Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Abstract

Objective: To provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012.” Design: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. Methods: The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. Results: The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. Conclusions: Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.

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Affiliated Institutions

• St. Michael's Hospital CA
• University of Ulsan KR
• University of Manitoba CA
• Pernod Ricard (France) FR
• University College London GB
• Hadassah Medical Center IL
• Centro Hospitalar de Lisboa Central PT
• Wolfson Foundation GB
• Vall d'Hebron Hospital Universitari ES
• Christiana Care Health System US
• King Abdullah University of Science and Technology SA
• Methodist Hospital US
• Brown University US
• Emory University Hospital US
• Sunnybrook Health Science Centre CA
• Central America Health Sciences University BZ
• Cooper University Health Care US
• UNSW Sydney AU
• California Pacific Medical Center US
• University of Amsterdam NL
• Nepean Hospital AU
• Hospital de Clínicas de Porto Alegre BR
• Rigshospitalet DK
• Massachusetts General Hospital US
• St George's Hospital GB
• University of Kansas Medical Center US
• University of Pittsburgh US
• University of Mississippi Medical Center US
• Università Cattolica del Sacro Cuore IT
• Health Sciences Centre CA
• Stanford University US
• Magna Graecia University IT
• Vivantes Klinikum DE
• Sapienza University of Rome IT
• Jackson Memorial Hospital US
• Centre Hospitalier Interrégional Edith Cavell BE
• Ulsan College KR
• New York University US
• McMaster University CA
• The University of Sydney AU
• Royal London Hospital GB
• Vanderbilt University Medical Center US
• Washington University in St. Louis US
• Fujita Health University JP
• Regions Hospital US
• Erasmus Hospital BE
• The London College GB

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