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Critical Care
Published in: Critical Care 1/2017

Open Access 01-12-2017 | Editorial

Fourth Surviving Sepsis Campaign’s hemodynamic recommendations: a step forward or a return to chaos?

Authors: Glenn Hernández, Jean-Louis Teboul

Published in: Critical Care | Issue 1/2017

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Excerpt

Since the first publication of the Surviving Sepsis Campaign (SSC) guidelines [1], a corpus of contradictory evidence as well as physiological objections on critical aspects of the hemodynamic resuscitation have emerged over time [2‐4]. The most recent SSC guidelines [5] have radically moved from a structured bundle approach to extremely broad recommendations, leaving fundamental pieces of care without clear-cut guidance for attending physicians, especially for monitoring and treatment. We wish to critically analyze potential negative consequences of some SSC’s hemodynamic recommendations and to discuss neglected areas. …
Literature
1.
Dellinger RP, Carlet JM, Masur H, Gerlach H, Calandra T, Cohen J, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004;32:858–73.CrossRefPubMed
2.
Finfer S. The Surviving Sepsis Campaign: robust evaluation and high-quality primary research is still needed. Crit Care Med. 2010;38:683–4.CrossRefPubMed
3.
4.
PRISM Investigators. Early, goal-directed therapy for septic shock--a patient-level meta-analysis. N Engl J Med. 2017 [Epub ahead of print].
5.
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving Sepsis Campaign: International guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017;43:304–77.CrossRefPubMed
6.
Carsetti A, Cecconi M, Rhodes A. Fluid bolus therapy: monitoring and predicting fluid responsiveness. Curr Opin Crit Care. 2015;21:388–94.CrossRefPubMed
7.
Cecconi M, De Backer D, Antonelli M, Beale R, Bakker J, Hofer C, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. Intensive Care Med. 2014;40:1795–815.CrossRefPubMedPubMedCentral
8.
Hamzaoui O, Georger JF, Monnet X, Ksouri H, Maizel J, Richard C, et al. Early administration of norepinephrine increases cardiac preload and cardiac output in septic patients with life-threatening hypotension. Crit Care. 2010;14:R142.CrossRefPubMedPubMedCentral
9.
Varpula M, Tallgren M, Saukkonen K, Voipio-Pulkki LM, Pettilä V. Hemodynamic variables related to outcome in septic shock. Intensive Care Med. 2005;31:1066–71.CrossRefPubMed
10.
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39:165–228.CrossRefPubMed
11.
Alegría L, Vera M, Dreyse J, Castro R, Carpio D, Henriquez C, et al. A hypoperfusion context may aid to interpret hyperlactatemia in sepsis-3 septic shock patients: a proof-of-concept study. Ann Intensive Care. 2017;7:29.CrossRefPubMedPubMedCentral
12.
Hernandez G, Bruhn A, Castro R, Regueira T. The holistic view on perfusion monitoring in septic shock. Curr Opinion Crit Care. 2012;18:280–6.CrossRef
13.
Vincent JL, Quintairos E, Silva A, Couto Jr L, Taccone FS. The value of blood lactate kinetics in critically ill patients: a systematic review. Crit Care. 2016;20:257.CrossRefPubMedPubMedCentral
14.
Hernandez G, Luengo C, Bruhn A, Kattan E, Friedman G, Ospina-Tascon GA, et al. When to stop septic shock resuscitation: clues from a dynamic perfusion monitoring. Ann Intensive Care. 2014;4:30.CrossRefPubMedPubMedCentral
Metadata
Title
Fourth Surviving Sepsis Campaign’s hemodynamic recommendations: a step forward or a return to chaos?
Authors
Glenn Hernández
Jean-Louis Teboul
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Critical Care / Issue 1/2017
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/s13054-017-1708-z

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