In a series of articles published last month in the Journal of the American Medical Association (JAMA) and released during the Society of Critical Care Medicine’s (SCCM) 45th Critical Care Congress, an international task force updated the definitions of sepsis and septic shock. The group’s recommendations not only advance new definitions for sepsis and septic shock, but also offer clinical guidance to help physicians more quickly identify patients with, or at risk of, sepsis.
Since its release, The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3), has been viewed more than 660,000 times. The article scored highest among outputs of a similar age from JAMA and is among one of the top 5% research outputs ever tracked by Altmetric. Learn more about this article’s Altmetric scores.
Clarifications from the Surviving Sepsis Campaign
In light of the new definitions, the Surviving Sepsis Campaign (SSC), a joint collaboration of SCCM and the European Society of Intensive Care Medicine committed to reducing mortality from severe sepsis and septic shock worldwide, issued a statement with important clarifications:
“For hospitals who have prepared for the transition, screening for early identification and treatment of patients with sepsis (formerly called severe sepsis) should continue essentially as has been previously recommended by SSC,” according to the statement.
The Campaign goes on to restate its recommendations for 1) screening and management of infection, 2) screening for organ dysfunction and management of sepsis (formerly called severe sepsis) and 3) identification and management of initial hypotension.
The Campaign also offers this clarification for practitioners regarding the quick Sepsis-Related Organ Failure Assessment (qSOFA): “Sepsis-3 introduces qSOFA as a tool for identifying patients at risk of sepsis with a higher risk of hospital death or prolonged intensive care unit (ICU) stay both inside and outside critical care units,” the authors note.
The Campaign notes the following two points:
- qSOFA does not define sepsis (but the presence of two qSOFA criteria is a predictor of both increased mortality and ICU stays of more than three days in non-ICU patients)
- The new sepsis definitions recommend using a change in baseline of the total SOFA score of two or more points to represent organ dysfunction
The Society has curated numerous resources related to the sepsis definitions at www.sccm.org/sepsisredefined. Among these resources are:
- The full presentation (video and PowerPoint slides) from the 45th Critical Care Congress that unveils the sepsis definitions
- A presentation (video and PowerPoint slides) from the 45th Critical Care Congress that focuses on how to use the new definitions
- Two different iCritical Care podcast interviews—one featuring Craig M. Coopersmith, MD, FCCM, and a follow-up with Clifford S. Deutschman, MS, MD, FCCM
- Accompanying articles by Seymour et al and Angus et al published in Critical Care Medicine, which present conceptual frameworks to help patients, clinicians, researchers and hospitals apply the new definitions
- An informative Medscape article centered on the updated definitions of sepsis and septic shock
Keep the discussion going on Twitter by using #SepsisRedefined. Join the #SepsisRedefined conversation group for updates on upcoming Twitter Chats on this topic.