• Journal of critical care · Apr 2022

    An international survey of adherence to Surviving Sepsis Campaign Guidelines 2016 regarding fluid resuscitation and vasopressors in the initial management of septic shock.

    • Eden Bitton, Shmuel Zimmerman, AzevedoLuciano Cesar PontesLCPEmergency Medicine Department, University of São Paulo, School of Medicine, São Paulo, Brazil., Dan Benhamou, Maurizio Cecconi, Jan J De Waele, Jeffrey Lipman, Ignacio Martin-Loeches, Romain Pirracchio, ScheerenThomas W LTWLDepartment of Anaesthesiology, University Medical Centre Groningen, Groningen, The Netherlands., Marc Leone, and Sharon Einav.
    • Intensive Care Unit of the Shaare Zedek Medical Center and the Hebrew University Faculty of Medicine, Jerusalem, Israel.
    • J Crit Care. 2022 Apr 1; 68: 144-154.

    BackgroundOur survey aimed to evaluate adherence to Surviving Sepsis Campaign (SSC) Guidelines 2016 among intensive care practitioners and to identify issues that remain controversial or lack clarity.MethodsMembers of the European Society of Intensive Care Medicine (ESICM) were surveyed using an anonymous web-based survey written by an international group of experts. The primary outcome measure was the rate of adherence to specific recommendations. Secondary outcomes were to describe areas of controversy and lack of data and to associate specific practices with clinician characteristics.ResultsOverall 820 questionnaires were completed. The SCC recommendations 2016 most adhered to were the choice of norepinephrine as first-line vasoactive drug (96.5%), vasopressor prescription based on therapeutic goal rather than dose (83.4%), targeting a specific mean arterial blood pressure during vasopressor use (77.9%), monitoring of blood pressure invasively (62.8%) and adding vasopressin or epinephrine as a second vasoactive agent (83.4%). We identified an internal conflict with regards to parallel versus sequential administration of fluids and vasoactive drugs and regional differences in practice that may be related to drug availabilities.ConclusionThe use of vasopressors and fluid use in septic shock is largely compliant with current guidelines but several controversies should be addressed in future guideline iterations.Copyright © 2021 Elsevier Inc. All rights reserved.

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