Intensive Care Medicine
Authors: Morten Hylander Møller, Waleed Alhazzani, Manu Shankar-Hari
Sepsis continues to be an important clinical and research
problem within critical care, as highlighted in the most recent literature.
The Surviving Sepsis Campaign bundle was updated in 2018 [1]. It was emphasised that within 1 h of
presentation with sepsis, clinicians should: measure lactate, obtain blood
cultures, administer broad-spectrum antimicrobials, begin fluid resuscitation
with 30 ml/kg crystalloids, and apply vasopressors in case of fluid
refractory shock. It was recommended that this new sepsis 1-h bundle should be used
systematically in emergency departments, wards, and ICUs to reduce the global
burden of sepsis [1]. While the 1-h bundle is welcomed and reasonable
from a patient perspective, the quality of evidence supporting some individual
elements of the bundle is low. A group of international experts representing
the European Society of Intensive Care Medicine and the Society of Critical
Care Medicine recently highlighted research priorities in the recent Surviving
Sepsis Campaign guideline [2]. The top-six research priorities were use of
personalised medicine in sepsis, fluid resuscitation, rapid diagnostic tests,
empirical antibiotic combination therapy, long-term outcomes, and predictors of
organ dysfunction…
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