Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock.
OBJECTIVE
To develop management guidelines for severe sepsis and septic shock that would be of practical use for the bedside clinician, under the auspices of the Surviving Sepsis Campaign, an international effort to increase awareness and improve outcome in severe sepsis.


METHODS
The process included a modified Delphi method, a consensus conference, several subsequent smaller meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. The modified Delphi methodology used for grading recommendations built upon a 2001 publication sponsored by the International Sepsis Forum. We undertook a systematic review of the literature graded along 5 levels to create recommendation grades from A-E, with A being the highest grade. Pediatric considerations were provided to contrast adult and pediatric management.


METHODS
Participants included 44 critical care and infectious disease experts representing 11 international organizations.


RESULTS
A total of 46 recommendations plus pediatric management considerations.


CONCLUSIONS
Evidence-based recommendations can be made regarding many aspects of the acute management of sepsis and septic shock that will hopefully translate into improved outcomes for the critically ill patient. The impact of these guidelines will be formally tested and guidelines updated annually, and even more rapidly when some important new knowledge becomes available.
Section of Critical Care Medicine, Cooper University Hospital, One Cooper Plaza, 393 Dorrance, Camden, NJ 08103, USA.
R Phillip
RP
Dellinger
Jean M
JM
Carlet
Henry
H
Masur
Herwig
H
Gerlach
Thierry
T
Calandra
Jonathan
J
Cohen
Juan
J
Gea-Banacloche
Didier
D
Keh
John C
JC
Marshall
Margaret M
MM
Parker
Graham
G
Ramsay
Janice L
JL
Zimmerman
Jean-Louis
JL
Vincent
M M
MM
Levy
D000328:Adult; D000698:Analgesia / Q000592:standards; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001639:Bicarbonates / Q000627:therapeutic use; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D019148:Neuromuscular Blockade / Q000592:standards; D017410:Practice Guidelines as Topic; D017582:Renal Replacement Therapy / Q000592:standards; D012128:Respiratory Distress Syndrome / Q000517:prevention & control / Q000628:therapy; D018805:Sepsis / Q000175:diagnosis / Q000628:therapy*; D012772:Shock, Septic / Q000175:diagnosis / Q000628:therapy*; D013256:Steroids / Q000627:therapeutic use; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D001639:Bicarbonates; D001786:Blood Glucose; D002316:Cardiotonic Agents; D006993:Hypnotics and Sedatives; D013256:Steroids; D014662:Vasoconstrictor Agents