The Surviving Sepsis Campaign (SSC) is a global initiative to bring together professional organizations in reducing mortality from sepsis. The purpose of the SSC is to create an international collaborative effort to improve the treatment of sepsis and reduce the high mortality rate associated with the condition. The Surviving Sepsis Campaign and the Institute for Healthcare Improvement have teamed up to achieve a 25 percent reduction in sepsis mortality by 2009.[1] The guidelines were updated in 2016 [2][3] and again in 2021.[4]
Mortality associated with severe sepsis remains high at 30-50%. When shock is present, mortality is reported to be even higher at around 50-60%. Approximately 1400 people die from sepsis each day throughout the world.
In the U.S. there are approximately 750,000 new sepsis cases each year, with at least 210,000 fatalities and this is reported to be same throughout Europe. As medicine becomes more advanced, with invasive procedures and immunosuppression, the incidence of sepsis is likely to increase even more.
Sepsis is one of the complications of Coronavirus disease 2019. In 2020, the campaign produced Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019.[5][6]
Facilitating data collection for the purposes of audit and feedback (SSC Guidelines 2008)
Using bundles in health careedit
Using bundles in health care simplifies the complex processes of the care of patients with severe sepsis. A bundle is a selected set of elements of care distilled from evidence-based practice guidelines that, when implemented as a group, have an effect on outcomes beyond implementing the individual elements alone. Each hospital's sepsis protocol may be customized, but it must meet the standards created by the bundle.
The first 6-hour SSC Resuscitation Bundle includes:
Broad-spectrum antibiotics administered within two hours of admission/diagnosis. For every hour a patient is denied AB therapy after the onset of septic shock, the patient's chance of survival is reduced by 7.9% (Survivesepsis.org 2005). The 2012 guidelines differ: Administration of broad-spectrum antimicrobials therapy within 1 hr of recognition of septic shock (1B) and severe sepsis without septic shock.[7]
In the event of hypotension and/or lactate > 4 mmol/L, delivering an initial minimum of 20 ml/kg of crystalloid or 5mls/kg of colloid. Recent updates to Surviving Sepsis Campaign recommend 30ml/kg bolus.
Apply vasopressors, usually noradrenaline for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure (MAP) > 65 mm Hg, in the event of persistent hypotension despite fluid resuscitation (septic shock) and/or lactate > 4 mmol/L (36 mg/dl):
To achieve central venous oxygen saturation (ScvO2) of > 70%
To achieve MAP > 65 mmHg and a urine output of > 0.5 ml/kg/h
The 24-hour SSC Management Bundle includes:
Low-dose steroids administered for septic shock in accordance with a standardized ICU policy
Glucose control maintained below upper limit of normal (8.3 mmol/L) with an insulin sliding scale regime (usually short-acting insulin such as Human Actrapid)
Lung Protective Ventilator Strategy utilising 5-8 mls/kg tidal volumes for mechanically ventilated patients to avoid volutrauma and barotrauma.
Referencesedit
^Dellinger RP, Levy MM, Carlet JM, et al. (January 2008). "Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008". Intensive Care Med. 34 (1): 17–60. doi:10.1007/s00134-007-0934-2. PMC2249616. PMID 18058085.
^Rhodes, Andrew; Evans, Laura E.; Alhazzani, Waleed; Levy, Mitchell M.; Antonelli, Massimo; Ferrer, Ricard; Kumar, Anand; Sevransky, Jonathan E.; Sprung, Charles L. (2017-01-18). "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016" (PDF). Intensive Care Medicine. 43 (3): 304–377. doi:10.1007/s00134-017-4683-6. ISSN 0342-4642. PMID 28101605.
^Rhodes, Andrew; Evans, Laura E.; Alhazzani, Waleed; Levy, Mitchell M.; Antonelli, Massimo; Ferrer, Ricard; Kumar, Anand; Sevransky, Jonathan E.; Sprung, Charles L.; Nunnally, Mark E.; Rochwerg, Bram (2017). "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock". Critical Care Medicine. 45 (3): 486–552. doi:10.1097/CCM.0000000000002255. ISSN 0090-3493. PMID 28098591. S2CID 52827184.
^Evans, Laura1; Rhodes, Andrew2; Alhazzani, Waleed3; Antonelli, Massimo4; Coopersmith, Craig M. Surviving Sepsis Campaign, Critical Care Medicine: October 4, 2021 - Volume - Issue - doi:10.1097/CCM.0000000000005337
^Liam Davenport (31 March 2020), Top 10 Must-Dos in ICU in COVID-19 Include Prone Ventilation, Medscape
^Waleed Alhazzani1; et al. (2020), "Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19)" (PDF), Intensive Care Medicine and Critical Care Medicine, 46 (5): 854–887, doi:10.1007/s00134-020-06022-5, PMC7101866, PMID 32222812{{citation}}: CS1 maint: numeric names: authors list (link)
^Dellinger, RP; Levy, MM; et, al (February 2013). "Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012". Critical Care Medicine. 41 (2): 580–637. doi:10.1097/CCM.0b013e31827e83af. PMID 23353941. S2CID 34855187.
External linksedit
Official site
January 01, 1970
surviving, sepsis, campaign, global, initiative, bring, together, professional, organizations, reducing, mortality, from, sepsis, purpose, create, international, collaborative, effort, improve, treatment, sepsis, reduce, high, mortality, rate, associated, with. The Surviving Sepsis Campaign SSC is a global initiative to bring together professional organizations in reducing mortality from sepsis The purpose of the SSC is to create an international collaborative effort to improve the treatment of sepsis and reduce the high mortality rate associated with the condition The Surviving Sepsis Campaign and the Institute for Healthcare Improvement have teamed up to achieve a 25 percent reduction in sepsis mortality by 2009 1 The guidelines were updated in 2016 2 3 and again in 2021 4 Surviving Sepsis Campaign Contents 1 Relevance 2 Approach 3 Using bundles in health care 4 References 5 External linksRelevance editMortality associated with severe sepsis remains high at 30 50 When shock is present mortality is reported to be even higher at around 50 60 Approximately 1400 people die from sepsis each day throughout the world In the U S there are approximately 750 000 new sepsis cases each year with at least 210 000 fatalities and this is reported to be same throughout Europe As medicine becomes more advanced with invasive procedures and immunosuppression the incidence of sepsis is likely to increase even more Sepsis is one of the complications of Coronavirus disease 2019 In 2020 the campaign produced Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 5 6 Approach editThis is done using a six pronged approach Building awareness of sepsis Improving diagnosis Increasing the use of appropriate treatment Educating healthcare professionals Improving post intensive care unit ICU care Developing guidelines of care Facilitating data collection for the purposes of audit and feedback SSC Guidelines 2008 Using bundles in health care editUsing bundles in health care simplifies the complex processes of the care of patients with severe sepsis A bundle is a selected set of elements of care distilled from evidence based practice guidelines that when implemented as a group have an effect on outcomes beyond implementing the individual elements alone Each hospital s sepsis protocol may be customized but it must meet the standards created by the bundle The first 6 hour SSC Resuscitation Bundle includes Blood cultures obtained prior to antibiotic administration serum lactate measured Broad spectrum antibiotics administered within two hours of admission diagnosis For every hour a patient is denied AB therapy after the onset of septic shock the patient s chance of survival is reduced by 7 9 Survivesepsis org 2005 The 2012 guidelines differ Administration of broad spectrum antimicrobials therapy within 1 hr of recognition of septic shock 1B and severe sepsis without septic shock 7 Further management is centered on Early Goal Directed Therapy EGDT In the event of hypotension and or lactate gt 4 mmol L delivering an initial minimum of 20 ml kg of crystalloid or 5mls kg of colloid Recent updates to Surviving Sepsis Campaign recommend 30ml kg bolus Apply vasopressors usually noradrenaline for hypotension not responding to initial fluid resuscitation to maintain mean arterial pressure MAP gt 65 mm Hg in the event of persistent hypotension despite fluid resuscitation septic shock and or lactate gt 4 mmol L 36 mg dl Resuscitation Goals are To achieve central venous pressure CVP of gt 8 mm Hg To achieve central venous oxygen saturation ScvO2 of gt 70 To achieve MAP gt 65 mmHg and a urine output of gt 0 5 ml kg h The 24 hour SSC Management Bundle includes Low dose steroids administered for septic shock in accordance with a standardized ICU policy Glucose control maintained below upper limit of normal 8 3 mmol L with an insulin sliding scale regime usually short acting insulin such as Human Actrapid Lung Protective Ventilator Strategy utilising 5 8 mls kg tidal volumes for mechanically ventilated patients to avoid volutrauma and barotrauma References edit Dellinger RP Levy MM Carlet JM et al January 2008 Surviving Sepsis Campaign international guidelines for management of severe sepsis and septic shock 2008 Intensive Care Med 34 1 17 60 doi 10 1007 s00134 007 0934 2 PMC 2249616 PMID 18058085 Rhodes Andrew Evans Laura E Alhazzani Waleed Levy Mitchell M Antonelli Massimo Ferrer Ricard Kumar Anand Sevransky Jonathan E Sprung Charles L 2017 01 18 Surviving Sepsis Campaign International Guidelines for Management of Sepsis and Septic Shock 2016 PDF Intensive Care Medicine 43 3 304 377 doi 10 1007 s00134 017 4683 6 ISSN 0342 4642 PMID 28101605 Rhodes Andrew Evans Laura E Alhazzani Waleed Levy Mitchell M Antonelli Massimo Ferrer Ricard Kumar Anand Sevransky Jonathan E Sprung Charles L Nunnally Mark E Rochwerg Bram 2017 Surviving Sepsis Campaign International Guidelines for Management of Sepsis and Septic Shock Critical Care Medicine 45 3 486 552 doi 10 1097 CCM 0000000000002255 ISSN 0090 3493 PMID 28098591 S2CID 52827184 Evans Laura1 Rhodes Andrew2 Alhazzani Waleed3 Antonelli Massimo4 Coopersmith Craig M Surviving Sepsis Campaign Critical Care Medicine October 4 2021 Volume Issue doi 10 1097 CCM 0000000000005337 Liam Davenport 31 March 2020 Top 10 Must Dos in ICU in COVID 19 Include Prone Ventilation Medscape Waleed Alhazzani1 et al 2020 Surviving Sepsis Campaign Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 COVID 19 PDF Intensive Care Medicine and Critical Care Medicine 46 5 854 887 doi 10 1007 s00134 020 06022 5 PMC 7101866 PMID 32222812 a href Template Citation html title Template Citation citation a CS1 maint numeric names authors list link Dellinger RP Levy MM et al February 2013 Surviving sepsis campaign international guidelines for management of severe sepsis and septic shock 2012 Critical Care Medicine 41 2 580 637 doi 10 1097 CCM 0b013e31827e83af PMID 23353941 S2CID 34855187 External links editOfficial site Retrieved from https en wikipedia org w index php title Surviving Sepsis Campaign amp oldid 1192526415, wikipedia, wiki, book, books, library,
