Tag Archives: Sepsis

Translations of Sepsis Guidelines

In its effort to reduce mortality from severe sepsis and septic shock worldwide, the Surviving Sepsis Campaign recently released translations of its guidelines in several languages:

Titled “Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock 2016,” the guidelines were originally published in the March 2017 issue of Critical Care Medicine.

Access the Surviving Sepsis Campaign guidelines online and download the translations for free.

Prehospital Antibiotics for Sepsis

Due to the high prevalence, morbidity, and mortality of sepsis, its early recognition and treatment has become a target for research and quality improvement over the past decade. Timely administration of antibiotics presumably improves outcomes. Therefore, Alam et al (Lancet Respir Med. 2017. [Epub ahead of print]) set out to identify whether diagnosis of sepsis and administration of antibiotics in the prehospital setting has an impact on survival.

Their study findings determined that they cannot recommend the initiation of antibiotics in septic patients in the prehospital setting.

Read the full Concise Critical Appraisal by logging in to the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Japanese Translation of Sepsis Guidelines

In its effort to reduce mortality from severe sepsis and septic shock worldwide, the Surviving Sepsis Campaign recently released the Japanese translation of the 2016 update of the Surviving Sepsis Campaign guidelines.

Titled “Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock 2016,” the guidelines were originally published in the March 2017 issue of Critical Care Medicine.

Access the Surviving Sepsis Campaign guidelines online and download the Japanese translation for free.

Classification of Patients with Sepsis

Despite years of research, sepsis remains a significant cause of mortality worldwide. The host response to sepsis is varied, and the patient response to directed therapies is heterogeneous, making it difficult to identify those at risk for poor outcomes using clinical features. Therefore, Scicluna et al (Lancet Respir Med. 2017;5:816-826) set out to identify biologically relevant molecular endotypes in patients with sepsis.

Their study methods and findings outline some early steps in the implementation of precision medicine in sepsis.

Read the full Concise Critical Appraisal by logging in to the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Predicting Mortality in Patients with Sepsis

Sepsis is an important cause of mortality in critical care, yet it is a heterogeneous syndrome in which patients with otherwise similar presenting clinical characteristics may rapidly progress to death or improve with minimal intervention. Therefore, Mikacenic et al (Am J Respir Crit Care Med. 2017;196:1004-1011) set out to assess the utility of a multibiomarker-based model to predict 28-day mortality among critically ill patients with at least two systemic inflammatory response syndrome criteria and/or sepsis.

Their findings offer insight into diagnostics to better prognosticate and ultimately direct specific therapies to achieve optimal clinical outcomes in heterogeneous groups of critically ill patients.

Read the full Concise Critical Appraisal by logging in to the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Antibiotic Timing and Mortality in Sepsis

The current standard of care for sepsis is the early administration of antibiotics. However, efforts to shorten time to antibiotic administration may also cause harm because more patients may receive unnecessary antibiotics. Liu et al  evaluated the association between antibiotic timing and mortality among patients with sepsis receiving antibiotics within 6 hours of emergency department registration.

They found that hourly delays in antibiotic administration for patients with sepsis were associated with increased odds of hospital mortality, even among patients who received antibiotics within 6 hours.

Read the full Concise Critical Appraisal by logging in to the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Outcomes of Mandated Sepsis Bundles

It is a requirement in some hospitals to follow protocols for the early identification and treatment of sepsis. However, there is controversy about whether more rapid treatment of sepsis improves outcomes in patients. Therefore, Seymour et al set out to determine the association between the time until completion of the 3-hour bundle and risk-adjusted mortality.

They found that more rapid completion of the 3-hour bundle of sepsis care and rapid antibiotics, but not rapid completion of an initial bolus of intravenous fluids, were associated with lower risk-adjusted in-hospital mortality.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Antibiotics for Treating Sepsis

Liaisons from the Society of Critical Care Medicine, Infectious Diseases Society of America, American College of Emergency Physicians, and the Society of Hospital Medicine recently released recommendations for the use of antibiotics for the treatment of sepsis.

Titled “Sepsis National Hospital Inpatient Quality Measure (SEP-1): Multi-stakeholder Work Group Recommendations for Appropriate Antibiotics for the Treatment of Sepsis,” the material was published in Clinical Infectious Diseases.

In this article, the work group promotes the appropriate use of antimicrobials to combat antimicrobial resistance and provides recommendations for appropriate antibiotics for the treatment of sepsis.

For more sepsis resources, visit www.survivingsepsis.org.

Sepsis Awareness Month

As part of Sepsis Awareness Month, the Global Sepsis Alliance and the World Health Organization are teaming up to host the World Sepsis Congress (WSC) Spotlight: Maternal and Neonatal Sepsis on September 12, 2017.

The WSC Spotlight is a free online congress in which 25 renowned experts from all around the world will give presentations on all aspects of maternal and neonatal sepsis, as well as give updates on sepsis in general.

For more information on the program, speakers, time zones, and to register for free, visit www.wscspotlight.org.

The U.S. Centers for Disease Control and Prevention (CDC) is also marking Sepsis Awareness Month, recently launching an initiative entitled Get Ahead of Sepsis that urges healthcare professionals, patients and caregivers to be alert to the symptoms, act fast if sepsis is suspected, and to prevent infections that can lead to sepsis. As part of this initiative, the CDC will be hosting the Get Ahead of Sepsis Twitter chat on September 12 at 12 p.m. ET. Join the conversation with #SepsisChat.

Also, if you have not already done so, you are also encouraged to review the new adult sepsis guidelines released earlier this year and to familiarize yourself with the Society of Critical Care Medicine’s Surviving Sepsis Campaign and its THRIVE initiative, which centers on addressing post-intensive care syndrome (PICS).

World Sepsis Congress

As part of Sepsis Awareness Month, the Global Sepsis Alliance and the World Health Organization are teaming up to host the World Sepsis Congress (WSC) Spotlight: Maternal and Neonatal Sepsis on September 12, 2017.

The WSC Spotlight is a free online congress in which 25 renowned experts from all around the world will give presentations on all aspects of maternal and neonatal sepsis, as well as give updates on sepsis in general.

For more information on the program, speakers, time zones, and to register for free, visit www.wscspotlight.org.

Also, if you have not already done so, you are also encouraged to review the new adult sepsis guidelines released earlier this year and to familiarize yourself with the Society of Critical Care Medicine’s Surviving Sepsis Campaign and its THRIVE initiative, which centers on addressing post-intensive care syndrome (PICS).

Resolution on Sepsis

On May 26, 2017, the World Health Organization (WHO) held its 70th World Health Assembly in Geneva, Switzerland. During this assembly, delegates agreed on a resolution to improve the prevention, diagnosis and treatment of sepsis, outlining these important actions for WHO:

  • Urge governments to strengthen policies and processes related to sepsis and emphasize the importance of reinforcing health worker training to more effectively diagnose and treat sepsis
  • Develop a report on sepsis and guidance for its prevention and management
  • Help countries develop the necessary infrastructure, laboratory capacity, strategies and tools to reduce the burden of sepsis
  • Assist developing countries in gaining access to quality, safe, efficacious and affordable sepsis treatments and tools for infection prevention and control

Learn more about this resolution on sepsis by visiting the WHO assembly website.

Sepsis and Therapeutic Interventions

The global burden of sepsis is substantial. Therefore, in a retrospective before-after clinical study, Marik et al compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a seven-month period (treatment group) at an intensive care unit (ICU) at Sentara Norfolk General Hospital compared to a control group treated (without intravenous vitamin C or thiamine) during the preceding seven months at the same ICU. The primary outcome was hospital survival.

The study’s results suggest that the early use of intravenous vitamin C, together with corticosteroids and thiamine, may prove to be effective in preventing progressive organ dysfunction and in reducing the mortality of patients with severe sepsis and septic shock.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Hemodynamic Support Guidelines

The American College of Critical Care Medicine (ACCM) recently released guidelines addressing hemodynamic support of pediatric and neonatal septic shock.

Titled “American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock,” the material was published in the June 2017 issue of Critical Care Medicine.

This update of the 2007 ACCM guidelines is available for free download and includes major new recommendations such as the need to address hemodynamic support of septic shock at the institutional level.

Molecular Detection of Pathogens

Microbiological diagnosis of infections remains insufficient. The resulting empirical antimicrobial therapy leads to multidrug resistance and inappropriate treatments. Cambau et al therefore evaluated the cost-effectiveness of direct molecular detection of pathogens in blood for patients with severe sepsis, febrile neutropenia, and suspected infective endocarditis.

They found that the addition of molecular detection to standard care improves microbiological diagnosis and thus efficiency of healthcare resource usage in patients with severe sepsis.

Read the full Concise Critical Appraisal by logging into the SCCM eCommunity. Concise Critical Appraisal is a regular feature aimed at highlighting the best and most relevant literature from a variety of academic journals and encouraging discussion around recent studies and research.

Maternal Sepsis Webinar

Register today for a free webinar offering continuing education credits hosted by the Centers for Disease Control and Prevention (CDC) in partnership with the Society of Critical Care Medicine, the American Nurses Association, and the Association of Women’s Health, Obstetric & Neonatal Nurses. Leading sepsis experts will discuss the CDC’s recent sepsis Vital Signs and protocols for early recognition of maternal sepsis.

Featured speakers include:

  • Elizabeth Rochin, PhD, RN, NE-BC; Vice President of Nursing, Education and Practice; Association of Women’s Health, Obstetric and Neonatal Nurses
  • Seun Ross, DNP, MSN, CRNP-F, NP-C, NEA-BC; Director of Nursing Practice and Work Environment, American Nurses Association
  • Sean Townsend, MD; Vice President of Quality & Safety, California Pacific Medical Center
  • Lauren Epstein, MD, MSc; Medical Officer, CDC’s Division of Healthcare Quality Promotion
  • Katarina Lanner-Cusin, MD; Medical Director Women’s Services, Sutter Health, Alta Bates Summit Medical Center
  • Lori Olvera, DNP, RNC-OB, EFM-C; Bedside Nurse, Anderson Lucchetti Women’s and Children Hospital; Kaiser Permanente

Sepsis Standard Work: Improving Compliance with Early Recognition and Management of Perinatal Sepsis will take place on Wednesday, May 17, 2017, at 11:00 a.m. Eastern Time. Registration is complimentary for all participants. If you have any questions, please contact SCCM Customer Service at +1 847 827-6888.