The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)
Mervyn Singer,Clifford S. Deutschman,Christopher W. Seymour,Manu Shankar-Hari,Djillali Annane,Michael Bauer,Rinaldo Bellomo,Gordon R. Bernard,Jean-Daniel Chiche,Craig M. Coopersmith,Richard S. Hotchkiss,Mitchell M. Levy,John C. Marshall,Greg S. Martin,Steven M. Opal,Gordon D. Rubenfeld,Gordon D. Rubenfeld,Tom van der Poll,Jean Louis Vincent,Derek C. Angus +19 more
Reads0
Chats0
TLDR
The task force concluded the term severe sepsis was redundant and updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsi or at risk of developing sepsic shock.Abstract:
Importance Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. Objective To evaluate and, as needed, update definitions for sepsis and septic shock. Process A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Definitions and clinical criteria were generated through meetings, Delphi processes, analysis of electronic health record databases, and voting, followed by circulation to international professional societies, requesting peer review and endorsement (by 31 societies listed in the Acknowledgment). Key Findings From Evidence Synthesis Limitations of previous definitions included an excessive focus on inflammation, the misleading model that sepsis follows a continuum through severe sepsis to shock, and inadequate specificity and sensitivity of the systemic inflammatory response syndrome (SIRS) criteria. Multiple definitions and terminologies are currently in use for sepsis, septic shock, and organ dysfunction, leading to discrepancies in reported incidence and observed mortality. The task force concluded the term severe sepsis was redundant. Recommendations Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%. Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. In out-of-hospital, emergency department, or general hospital ward settings, adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes typical of sepsis if they have at least 2 of the following clinical criteria that together constitute a new bedside clinical score termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less. Conclusions and Relevance These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis.read more
Citations
More filters
Journal ArticleDOI
Prognostic Value of The Lactate/Albumin Ratio for Predicting 28-Day Mortality in Critically ILL Sepsis Patients.
Jikyoung Shin,Sung Yeon Hwang,Ik Joon Jo,Won Young Kim,Seung Mok Ryoo,Gu Hyun Kang,Kyuseok Kim,You Hwan Jo,Sung Phil Chung,Young Seon Joo,Jin Ho Beom,Young Hoon Yoon,Kap Su Han,Tae Ho Lim,Han Sung Choi,Woon Yong Kwon,Gil Joon Suh,Sung Hyuk Choi,Tae Gun Shin +18 more
TL;DR: The prognostic performance of the L/A ratio was superior to that of a single lactate measurement for predicting 28-day mortality of critically ill sepsis patients and can be a useful prognostic factor regardless of initial lactate level and the presence of hepatic or renal dysfunction.
Journal ArticleDOI
High-density lipoprotein (HDL) particle size and concentration changes in septic shock patients.
Sébastien Tanaka,Devy Diallo,Sandrine Delbosc,Claire Geneve,Nathalie Zappella,Jennyfer Yong-Sang,Jessica Patche,Anatole Harrois,Sophie Hamada,Erick Denamur,Philippe Montravers,Jacques Duranteau,Olivier Meilhac +12 more
TL;DR: The results emphasize that HDL levels are dramatically decreased in the acute phase of septic shock and that there is a shift toward large HDL particles, which may reflect a major dysfunction of these lipoproteins.
Posted ContentDOI
Clinical characteristics of 101 non-surviving hospitalized patients with COVID-19: A single center, retrospective study
Qiao Shi,Kailiang Zhao,Jia Yu,Fang Jiang,Jiarui Feng,Kaiping Zhao,Xiaoyi Zhang,Xiaoyan Chen,Peng Hu,Yupu Hong,Man Li,Fang Liu,Chen Chen,Weixing Wang +13 more
TL;DR: Older patients (>70 years) with comorbidities had a steeply increased risk of death with COVID-19 and Elevated high sensitivity troponin, neutrophils and depressed oxygen saturation predicted the rapid death of patients.
Journal ArticleDOI
Procalcitonin as a prognostic marker for sepsis based on SEPSIS-3.
TL;DR: The objective of this study was to evaluate procalcitonin (PCT) for the diagnosis and prognosis of sepsis using SEPSIS‐3.
Journal ArticleDOI
Early PREdiction of sepsis using leukocyte surface biomarkers: the ExPRES-sepsis cohort study.
Manu Shankar-Hari,Manu Shankar-Hari,Deepankar Datta,Julie Wilson,Julie Wilson,Valentina Assi,Jacqueline Stephen,Christopher J. Weir,Jillian Rennie,Jean Antonelli,Anthony Bateman,Jennifer M Felton,Noel L. Warner,Kevin Judge,Jim Keenan,Alice Wang,Tony Burpee,Alun K Brown,Sion M. Lewis,Tracey Mare,Alistair I Roy,John Wright,Gillian Hulme,Ian Dimmick,Alasdair Gray,Adriano G. Rossi,A. John Simpson,Andrew Conway Morris,Timothy S. Walsh +28 more
TL;DR: From a large panel of leukocyte biomarkers, immunosuppression biomarkers were associated with subsequent sepsis in ED patients with suspected acute infection.
References
More filters
Journal ArticleDOI
Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis
Roger C. Bone,Robert A. Balk,F. B. Cerra,R. P. Dellinger,A. M. Fein,William A. Knaus,Roland M. H. Schein,W. J. Sibbald +7 more
TL;DR: An American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference was held in Northbrook in August 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae as mentioned in this paper.
Journal ArticleDOI
Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012.
R. P. Dellinger,Mitchell M. Levy,Andrew Rhodes,Djillali Annane,Herwig Gerlach,Steven M. Opal,Jonathan E. Sevransky,Charles L. Sprung,Ivor S. Douglas,Roman Jaeschke,Tiffany M. Osborn,Mark E. Nunnally,Konrad Reinhart,Ruth M. Kleinpell,Derek C. Angus,Clifford S. Deutschman,Flávia Ribeiro Machado,Gordon D. Rubenfeld,Steven A R Webb,Richard Beale,Jean Louis Vincent,Rui Moreno +21 more
TL;DR: An update to the “Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock,” last published in 2008 is provided.
Journal ArticleDOI
The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine.
Jean Louis Vincent,R. Moreno,Jukka Takala,Sheila Willatts,A. de Mendonça,Hajo A. Bruining,C. K. Reinhart,P. M. Suter,L. G. Thijs +8 more
TL;DR: The ESICM developed a so-called sepsis-related organ failure assessment (SOFA) score to describe quantitatively and as objectively as possible the degree of organ dysfunction/failure over time in groups of patients or even in individual patients.
Journal ArticleDOI
Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care.
Derek C. Angus,Walter T. Linde-Zwirble,Jeffrey Lidicker,Gilles Clermont,Joseph A. Carcillo,Michael R. Pinsky +5 more
TL;DR: Severe sepsis is a common, expensive, and frequently fatal condition, with as many deaths annually as those from acute myocardial infarction, and is especially common in the elderly and is likely to increase substantially as the U.S. population ages.
Journal ArticleDOI
Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock, 2012
R. Phillip Dellinger,Mitchell M. Levy,Andrew Rhodes,Djillali Annane,Herwig Gerlach,Steven M. Opal,Jonathan E. Sevransky,Charles L. Sprung,Ivor S. Douglas,Roman Jaeschke,Tiffany M. Osborn,Mark E. Nunnally,Sean R. Townsend,Konrad Reinhart,Ruth M. Kleinpell,Derek C. Angus,Clifford S. Deutschman,Flávia Ribeiro Machado,Gordon D. Rubenfeld,Steven A R Webb,Richard Beale,Jean Louis Vincent,Rui Moreno +22 more
TL;DR: A consensus committee of 68 international experts representing 30 international organizations was convened in 2008 to provide an update to the "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock".
Related Papers (5)
Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012.
R. P. Dellinger,Mitchell M. Levy,Andrew Rhodes,Djillali Annane,Herwig Gerlach,Steven M. Opal,Jonathan E. Sevransky,Charles L. Sprung,Ivor S. Douglas,Roman Jaeschke,Tiffany M. Osborn,Mark E. Nunnally,Konrad Reinhart,Ruth M. Kleinpell,Derek C. Angus,Clifford S. Deutschman,Flávia Ribeiro Machado,Gordon D. Rubenfeld,Steven A R Webb,Richard Beale,Jean Louis Vincent,Rui Moreno +21 more
Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016
Andrew Rhodes,Laura Evans,Waleed Alhazzani,Mitchell M. Levy,Massimo Antonelli,Ricard Ferrer,Anand Kumar,Jonathan E. Sevransky,Charles L. Sprung,Mark E. Nunnally,Bram Rochwerg,Gordon D. Rubenfeld,Derek C. Angus,Djillali Annane,Richard Beale,Geoffrey J. Bellinghan,Gordon R. Bernard,Jean Daniel Chiche,Craig M. Coopersmith,Daniel De Backer,Craig French,Seitaro Fujishima,Herwig Gerlach,Jorge Hidalgo,Steven M. Hollenberg,Alan E. Jones,Dilip R. Karnad,Ruth M. Kleinpell,Younsuck Koh,Thiago Lisboa,Flávia Ribeiro Machado,John J. Marini,John C. Marshall,John E. Mazuski,Lauralyn McIntyre,Anthony S. McLean,Sangeeta Mehta,Rui Moreno,John Myburgh,Paolo Navalesi,Osamu Nishida,Tiffany M. Osborn,Anders Perner,Colleen M. Plunkett,Marco Ranieri,Christa A. Schorr,Maureen A. Seckel,Christopher W. Seymour,Lisa Shieh,Khalid A. Shukri,Steven Q. Simpson,Mervyn Singer,B. Taylor Thompson,Sean R. Townsend,Thomas Van der Poll,Jean Louis Vincent,W. Joost Wiersinga,Janice L. Zimmerman,R. Phillip Dellinger +58 more