Time to Treatment and Mortality during Mandated Emergency Care for Sepsis

New England Journal of Medicine May 21 2017

In 2013, New York began requiring 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. The article concludes that a more rapid completion of a 3-hour bundle of sepsis care and rapid administration of antibiotics, but not rapid completion of an initial bolus of intravenous fluids, were associated with lower risk-adjusted in-hospital mortality

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

Intensive Care Med. 2017 Jan 18. doi: 10.1007/s00134-017-4683-6. [Epub ahead of print]

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A consensus committee of 55 international experts representing 25 international organizations was convened to provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012. The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. 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. In conclusion, 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.