Early hemodynamic resuscitation of septic shock: what do the new Surviving Sepsis Campaign guidelines really provide?

AbstractEarly management of sepsis and septic shock is crucial for patients’ prognosis. As the Emergency Department (ED) is the place where the first medical contact for septic patients is likely to occur, emergency physicians play an essential role in the early phases of patient management, which consists of accurate initial diagnosis, resuscitation, and early antibiotic treatment. Since the issuing of the Surviving Sepsis Campaign guidelines in 2016, several studies have been published on different aspects of sepsis management, adding a substantial amount of new information on the pathophysiology and treatment of sepsis and septic shock. In light of this emerging evidence, the present narrative review provides a comprehensive account of the recent advances in septic patient management in the ED.

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Infectious Diseases Society of America (IDSA) POSITION STATEMENT: Why IDSA Did Not Endorse the Surviving Sepsis Campaign Guidelines

Clinical Infectious Diseases ◽

10.1093/cid/cix997 ◽

2017 ◽

Vol 66 (10) ◽

pp. 1631-1635 ◽

Cited By ~ 52

Author(s):

◽

Andre C Kalil ◽

David N Gilbert ◽

Dean L Winslow ◽

Henry Masur ◽

...

Keyword(s):

Septic Shock ◽

Critical Care ◽

Infectious Diseases ◽

Position Statement ◽

Critical Care Medicine ◽

Surviving Sepsis Campaign ◽

Diagnosis And Therapy

The Infectious Diseases Society of America elected not to endorse the Surviving Sepsis Campaign Guidelines due to lack of agreement with the Society of Critical Care Medicine regarding specific recommendations related to diagnosis and therapy for patients with apparent or documented sepsis/septic shock.

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Adherence to surviving sepsis campaign guidelines 2016 regarding fluid resuscitation and vasopressors in the initial management of septic shock: The emerging part of the iceberg!

Journal of Critical Care ◽

10.1016/j.jcrc.2021.11.015 ◽

2021 ◽

Author(s):

Mathieu Jozwiak ◽

Olfa Hamzaoui

Keyword(s):

Septic Shock ◽

Fluid Resuscitation ◽

Surviving Sepsis Campaign ◽

Initial Management

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Hydrocortisone Therapy for Patients with Septic Shock

50 Studies Every Intensivist Should Know ◽

10.1093/med/9780190467654.003.0049 ◽

2018 ◽

pp. 301-306

Author(s):

Ryan J. Horvath ◽

Edward Bittner

Keyword(s):

Septic Shock ◽

Study Design ◽

Steroid Therapy ◽

Clinical Case ◽

Low Dose ◽

Vasopressor Therapy ◽

Surviving Sepsis Campaign ◽

Number Of Patients ◽

Study Intervention

This chapter provides a summary of the landmark study known as the CORTICUS trial. Among patients suffering from septic shock, does low dose hydrocortisone improve mortality? Starting with that question, it describes the basics of the study, including funding, study location, the population studies, number of patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case. The CORTICUS trial failed to demonstrate a benefit on mortality with steroid therapy among patients with septic shock. Based on CORTICUS and other studies, the Surviving Sepsis Campaign guidelines no longer recommend steroids for all patients with septic shock. Corticosteroids should be considered, however, for patients with septic shock who do not respond to fluids and vasopressor therapy.

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