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

被引：4558

作者：

Rhodes, Andrew ^{[1
]}

Evans, Laura E. ^{[2
]}

Alhazzani, Waleed ^{[3
]}

Levy, Mitchell M. ^{[4
]}

Antonelli, Massimo ^{[5
]}

Ferrer, Ricard ^{[6
]}

Kumar, Anand ^{[7
]}

Sevransky, Jonathan E. ^{[8
]}

Sprung, Charles L. ^{[9
]}

Nunnally, Mark E. ^{[2
]}

Rochwerg, Bram ^{[3
]}

Rubenfeld, Gordon D. ^{[10
]}

Angus, Derek C. ^{[11
]}

Annane, Djillali ^{[12
]}

Beale, Richard J. ^{[13
]}

Bellinghan, Geoffrey J. ^{[14
]}

Bernard, Gordon R. ^{[15
]}

Chiche, Jean-Daniel ^{[16
]}

Coopersmith, Craig ^{[8
]}

De Backer, Daniel P. ^{[17
]}

French, Craig J. ^{[18
]}

Fujishima, Seitaro ^{[19
]}

Gerlach, Herwig ^{[20
]}

Hidalgo, Jorge Luis ^{[21
]}

Hollenberg, Steven M. ^{[22
]}

Jones, Alan E. ^{[23
]}

Karnad, Dilip R. ^{[24
]}

Kleinpell, Ruth M. ^{[25
]}

Koh, Younsuck ^{[26
]}

Lisboa, Thiago Costa ^{[27
]}

Machado, Flavia R. ^{[28
]}

Marini, John J. ^{[29
]}

Marshall, John C. ^{[30
]}

Mazuski, John E. ^{[31
]}

McIntyre, Lauralyn A. ^{[32
]}

McLean, Anthony S. ^{[33
]}

Mehta, Sangeeta ^{[34
]}

Moreno, Rui P. ^{[35
]}

Myburgh, John ^{[36
]}

Navalesi, Paolo ^{[37
]}

Nishida, Osamu ^{[38
]}

Osborn, Tiffany M. ^{[31
]}

Perner, Anders ^{[39
]}

Plunkett, Colleen M. ^{[25
]}

Ranieri, Marco ^{[40
]}

Schorr, Christa A. ^{[22
]}

Seckel, Maureen A. ^{[41
]}

Seymour, Christopher W. ^{[42
]}

Shieh, Lisa ^{[43
]}

Shukri, Khalid A. ^{[44
]}

机构：

[1] St George Hosp, London, England

[2] NYU, Sch Med, New York, NY USA

[3] McMaster Univ, Hamilton, ON, Canada

[4] Brown Univ, Sch Med, Providence, RI 02912 USA

[5] Univ Cattolica Sacro Cuore, Inst Anestesiol & Rianimaz, Rome, Italy

[6] Vall dHebron Univ Hosp, Barcelona, Spain

[7] Univ Manitoba, Winnipeg, MB, Canada

[8] Emory Univ Hosp, Atlanta, GA USA

[9] Hadassah Hebrew Univ, Med Ctr, Jerusalem, Israel

[10] Sunnybrook Hlth Sci Ctr, Toronto, ON, Canada

[11] Univ Pittsburgh, Crit Care Med CRISMA Lab, Pittsburgh, PA USA

[12] Hop Raymond Poincare, Garches, France

[13] St Thomas Hosp, London, England

[14] Univ Coll London Hosp, London, England

[15] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[16] Serv Reanimat Med, Paris, France

[17] CHIREC Hosp, Braine Lalleud, Belgium

[18] Western Hosp, Melbourne, Vic, Australia

[19] Keio Univ, Sch Med, Tokyo, Japan

[20] Vivantes Klinikum Neukolln, Berlin, Germany

[21] Karl Heusner Mem Hosp, Belize Healthcare Partners, Belize City, Belize

[22] Cooper Hlth Syst, Camden, NJ USA

[23] Univ Mississippi, Med Ctr, Jackson, MS 39216 USA

[24] Jupiter Hosp, Thana, India

[25] Rush Univ, Med Ctr, Chicago, IL 60612 USA

[26] Univ Ulsan, Coll Med, ASAN Med Ctr, Seoul, South Korea

[27] Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil

[28] Univ Fed Sao Paulo, Sao Paulo, Brazil

[29] Reg Hosp, St Paul, MN USA

[30] St Michaels Hosp, Toronto, ON, Canada

[31] Washington Univ, Sch Med, St Louis, MO USA

[32] Ottawa Hosp, Ottawa, ON, Canada

[33] Univ Sydney, Nepean Hosp, Penrith, NSW, Australia

[34] Mt Sinai Hosp, Toronto, ON, Canada

[35] Ctr Hosp Lisboa Cent, UCINC, Lisbon, Portugal

[36] Univ New South Wales, Sydney, NSW, Australia

[37] Magna Graecia Univ Catanzaro, Catanzaro, Italy

[38] Fujita Hlth Univ, Sch Med, Toyoake, Aichi, Japan

[39] Rigshosp, Copenhagen, Denmark

[40] Univ Sapienza, Rome, Italy

[41] Christiana Care Hlth Syst, Newark, DE USA

[42] Univ Pittsburgh, Sch Med, Pittsburgh, PA USA

[43] Stanford Univ, Sch Med, Stanford, CA 94305 USA

[44] Kaust Med Serv, Thuwal, Saudi Arabia

[45] Univ Kansas, Med Ctr, Kansas City, KS 66103 USA

[46] Wolfson Inst Biomed Res, London, England

[47] Massachusetts Gen Hosp, Boston, MA 02114 USA

[48] Calif Pacific Med Ctr, San Francisco, CA USA

[49] Univ Amsterdam, Amsterdam, Netherlands

[50] Erasme Univ Hosp, Brussels, Belgium

来源：

CRITICAL CARE MEDICINE | 2017年 / 45卷 / 03期

关键词：

evidence-based medicine; Grading of Recommendations Assessment; Development; and Evaluation criteria; guidelines; infection; sepsis; sepsis bundles; sepsis syndrome; septic shock; Surviving Sepsis Campaign; CRITICALLY-ILL PATIENTS; INTENSIVE-CARE-UNIT; RESPIRATORY-DISTRESS-SYNDROME; ACUTE LUNG INJURY; INFECTIOUS-DISEASES SOCIETY; COMBINATION ANTIBIOTIC-THERAPY; RENAL-REPLACEMENT THERAPY; STRESS-ULCER PROPHYLAXIS; CLINICAL-PRACTICE GUIDELINES; END-EXPIRATORY PRESSURE;

D O I：

10.1097/CCM.0000000000002255

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

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.

引用

页码：486 / 552

页数：67

共 649 条

[41] Vasopressors for the Treatment of Septic Shock: Systematic Review and Meta-Analysis [J].