The Systemic Inflammation and Sepsis section is led by Massimo Girardis.
Sepsis and Severe Infections
This 2-day e-course blends techniques that encourage maximum learning. Special attention is given to interactive activities, case-based discussions, workshops and problem-oriented approaches.
Dates: February 22-23, 2024
The COVID-19 ALIVE course is a unique learning opportunity, structured and comprehensive addressing COVID-19 in critically ill patients in LMICs.
The course content specifically addresses many common issues faced when caring for critically ill COVID-19 patients in LMICs.
Speakers from around the world will share their experiences and cover ten pertinent and key topics related to relevant aspects of the care of such patients.
The course is FREE of charge, whether you hold an ESICM membership or not.
Sepsis Assessment and Identification in Low Resource Settings (SAILORS). SAILORS Study Group, ESICM, SCCM collaboration.
Am J Respir Crit Care Med 2017;195:A5847
Abdominal Sepsis Study: Epidemiology of Etiology and Outcome is a multinational, prospective, observational study on intra-abdominal infections (IAIs) in critically ill patients with a special emphasis on epidemiology and outcomes.
Investigate microbiology and/or drug resistance patterns. Describe physician’s antimicrobial prescription patterns. Investigate outcomes (clinical response, need for surgical revision, length of hospitalisation, and mortality).
The trial aimed at identifying factors that determine the incidence, severity and the outcome from life-threatening infections (severe sepsis/septic shock) in patients admitted to High Dependency Units (HDUs) or Intensive Care Units (ICUs) with community acquired pneumonia (CAP) or with faecal peritonitis (FP).
Further information: www.ukccg-gains.org
François B. et al. Prospective evaluation of the efficacy, safety, and optimal biomarker enrichment strategy for nangibotide, a TREM-1 inhibitor, in patients with septic shock (ASTONISH): a double-blind, randomised, controlled, phase 2b trial. Lancet Respir Med 2023;epublished May 31st
Vacheron C-H. et al. Granulocyte-macrophage colony-stimulating factor (GM-CSF) in patients presenting sepsis-induced immunosuppression: The GRID randomized controlled trial. J Crit Care 2023;78:154330
Becker S. et al. Efficacy of CytoSorb®: a systematic review and meta-analysis. Crit Care 27, 215 (2023)
Rey S. et al. Hemoperfusion using the lps-selective mesoporous polymeric adsorbent in septic shock: a multicenter randomized clinical trial. Shock 2023;59(6):846-854
Pirracchio R. et al. Patient-Level Meta-Analysis of Low-Dose Hydrocortisone in Adults with Septic Shock. NEJM Evid 2023;2(6)
Guarino M. et al. 2023 Update on Sepsis and Septic Shock in Adult Patients: Management in the Emergency Department. J Clin Med 2023;12(9):3188
Li J. Research progress of viral sepsis: etiology, pathophysiology, diagnosis, and treatment. Emerg Crit Care Med 2023;epublished April 25th
Sivapalan P. et al. Lower vs Higher Fluid Volumes in Adult Patients with Sepsis – An Updated Systematic Review with Meta-Analysis and Trial Sequential Analysis. Chest 2023;epublished May 2nd
Ushio N. et al. Sepsis‐induced disseminated intravascular coagulation: an international estrangement of disease concept. Acute Med Surg 2023;10(1):e00843
Geng L. et al. Different Concentrations of Albumin Versus Crystalloid in Patients with Sepsis and Septic Shock: A Meta-Analysis of Randomized Clinical Trials. J Intensive Care Med 2023;epublished April 20th
Marques A. et al. Treatment Advances in Sepsis and Septic Shock: Modulating Pro- and Anti-Inflammatory Mechanisms. J Clin Med 2023;12(8):2892
Wang J. and Zhang G. Precision immunotherapy treatment for sepsis. Eur Rev Med Pharmacol Sci 2023;27(7):3142-3149
Maneta E. et al. Endothelial dysfunction and immunothrombosis in sepsis. Front Immunol 2023;14:1144229
Chancharoenthana W. at al. The leaky gut and the gut microbiome in sepsis – targets in research and treatment. Clin Sci 2023;137(8):645-662
Mehta Y. et al. Extracorporeal blood purification strategies in sepsis and septic shock: An insight into recent advancements. World J Crit Care Med 2023;12(2):71-88
Carsetti A. et al. Anesthetic management of patients with sepsis/septic shock. Front Med 2023;10:1150124
Bosch N. et al. Comparative Effectiveness of Fludrocortisone and Hydrocortisone vs Hydrocortisone Alone Among Patients With Septic Shock. JAMA Intern Med 2023;epublished March 27th
Lakbar I. et al. Interactions between Gender and Sepsis-Implications for the Future. Microorganisms 2023;11(3):746
Monnet X., Lai C. and Teboul J-L. How I personalize fluid therapy in septic shock?. Crit Care 2023;27:123
França A. The Role of Coagulase-Negative Staphylococci Biofilms on Late-Onset Sepsis: Current Challenges and Emerging Diagnostics and Therapies. Antibiotics 2023;12:554
Ibarra-Estrada M. Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial. Crit Care 2023;27:110
Daix T. et al. Intravenously administered interleukin-7 to reverse lymphopenia in patients with septic shock: a double-blind, randomized, placebo-controlled trial. Ann Intensive Care 2023;13:17
Liang B. et al. The outcome of IV vitamin C therapy in patients with sepsis or septic shock: a meta-analysis of randomized controlled trials. Crit Care 2023;27:109
Dellinger R.P. Surviving Sepsis Campaign. Crit Care Med 2023;51(4):431-444
Arora J. et al. Sepsis: Network Pathophysiology and implications for Early Diagnosis. Am J Physiol Regul 2023;epublished March 6th
Yoshihara I. et al. Sepsis-Associated Muscle Wasting: A Comprehensive Review from Bench to Bedside. Int J Mol Sci 2023;24(5):5040
Ferlini L. and Gaspard N. What’s new on septic encephalopathy? Ten things you need to know. Minerva Anestesiologica 2023;89(3):217-25
Ferreira T. et al. Sepsis biomarkers: a review of the diagnostic value of presepsin. Rev Med 2023;102(1):e-182916
Messmer A.S. Active fluid de-resuscitation in critically ill patients with septic shock: A systematic review and meta-analysis. Eur J Intern Med 2023;109:89-96
Roberson S.W. et al. Association of Vitamin C, Thiamine, and Hydrocortisone Infusion With Long-term Cognitive, Psychological, and Functional Outcomes in Sepsis Survivors: A Secondary Analysis of the Vitamin C, Thiamine, and Steroids in Sepsis Randomized Clinical Trial. JAMA Netw Open 2023;6(2):e230380
Zhang C. Platelet‑related parameters as potential biomarkers for the prognosis of sepsis. Exp Ther Med 2023;25(3):133
Zarbock A. et al. Sepsis-associated acute kidney injury: consensus report of the 28th Acute Disease Quality Initiative workgroup. Nat Rev Nephrol 2023;epublished February 23rd
Piva S. et al. Neurological complications of sepsis. Curr Opin Crit Care 2023;epublished February 16th
Cutuli S.L. et al. Antimicrobial Exposure in Critically Ill Patients with Sepsis-Associated Multi-Organ Dysfunction Requiring Extracorporeal Organ Support: A Narrative Review. Microorganisms 2023;11(2):473
Berlot B. et al. The Techniques of Blood Purification in the Treatment of Sepsis and Other Hyperinflammatory Conditions. J Clin Med 2023;12:1723
Delrue C. et al. Vitamin D Deficiency: An Underestimated Factor in Sepsis? Int J Mol Sci 2023;24(3):2924
Hofmaenner D.A. et al. Association Between Hypocholesterolemia and Mortality in Critically Ill Patients With Sepsis: A Systematic Review and Meta-Analysis. Crit Care Explor 2023;5(2):e0860
Reynolds P.M. et al. Restrictive Resuscitation in Patients with Sepsis and Mortality: A Systematic Review and Meta-Analysis with Trial Sequential Analysis. Pharmacotherapy 2023;epublished January 10th
Banothu K.K. et al. A Randomized Controlled Trial of Norepinephrine Plus Dobutamine Versus Epinephrine As First-Line Vasoactive Agents in Children With Fluid Refractory Cold Septic Shock. Crit Care Explor 2023;5(1):e0815
Póvoa P. et al. How to use biomarkers of infection or sepsis at the bedside: guide to clinicians. Intensive Care Med 2023;epublished January 2nd
Klinkmann G. et al. Therapeutic apheresis in sepsis. Ther Apher Dial 2022;26 Suppl 1:64-72
Pei F. et al. Expert consensus on the monitoring and treatment of sepsis-induced immunosuppression. Military Med Res 2022;9:74
Lin Y-M. et al. Association of sepsis-induced cardiomyopathy and mortality: a systematic review and meta-analysis. Ann Intensive Care 2022;12:112
Nazer L. et al. All-cause mortality in cancer patients treated for sepsis in intensive care units: a systematic review and meta-analysis. Support Care Cancer 2022;30(12):10099-10109
Qing-Quan L. et al. Early administration of hydrocortisone, vitamin C, and thiamine in adult patients with septic shock: a randomized controlled clinical trial. Crit Care 2022 Sep 28;26(1):295
Teboul J.L. How to integrate hemodynamic variables during resuscitation of septic shock? J Intensive Care Med 2022
Hernandez-Beeftink T. et al. A genome-wide association study of survival in patients with sepsis. Critical Care 2022; 26: 341
Sun T. et al. Efficacy of Levosimendan in the Treatment of Patients with Severe Septic Cardiomyopathy. J Cardiothor and Vasc Anesth 2022
Jozwiak M. et al. Alternatives to norepinephrine in septic shock: Which agents and when? J Intensive Med 2022; 2: 223-232
von Groote T. and Meersch-Dini M. Biomarkers for the Prediction and Judgement of Sepsis and Sepsis Complications: A Step towards precision medicine? J. Clin. Med. 2022, 11(19), 5782
Patel J.J. et al. High-Dose Intravenous Hydroxocobalamin (Vitamin B12) in Septic Shock: A Double-Blind, Allocation-Concealed, Placebo-Controlled Single-Center Pilot Randomized Controlled Trial (The IV-HOCSS Trial). Chest 2022; epublished September 26th
Van den Berghe G. et al. The hypothalamus-pituitary-adrenal axis in sepsis- and hyperinflammation-induced critical illness: Gaps in current knowledge and future translational research directions. eBioMedicine 2022;84:104284
Hyun D-G. et al. Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study. Crit Care 2022;26:280
Cou M. et al. Remote ischemic conditioning in septic shock: the RECO-Sepsis randomized clinical trial. Intensive Care Med 2022; epublished September 14th
Vincent J-L. et al. The End of “One Size Fits All” Sepsis Therapies: Toward an Individualized Approach. Biomedicines 2022;10:2260
Roggeveen L.F. et al. Right dose, right now: bedside, real-time, data-driven, and personalised antibiotic dosing in critically ill patients with sepsis or septic shock—a two-centre randomised clinical trial. Crit Care 2022;26:265
Zhang T. Use of dexmedetomidine in patients with sepsis: a systematic review and meta-analysis of randomized-controlled trials. Ann. Intensive Care 2022;12:81
Bruse N. Clinical sepsis phenotypes in critically ill COVID-19 patients. Crit Care 2022;26:244
Fage N. et al. Effects of mean arterial pressure target on mottling and arterial lactate normalization in patients with septic shock: a post hoc analysis of the SEPSISPAM randomized trial. Ann Intensive Care 202219;12(1):78
Cortegiani A. et al. Empiric treatment of patients with sepsis and septic shock and place in therapy of cefiderocol: a systematic review and expert opinion statement. J Anesth Analg Crit Care 2022;2:34
Patel S. et al. Sepsis Management for the Nephrologist. Clin J Am Soc Nephrol. 2022 Jun;17(6):880-889
Molinari L, et al. ProCESS and ProGReSS-AKI Investigators. Utility of Biomarkers for Sepsis-Associated Acute Kidney Injury Staging. JAMA Netw Open. 2022 May 2;5(5):e2212709
Hussain H. et al. Patient Stratification in Sepsis: Using Metabolomics to Detect Clinical Phenotypes, Sub-Phenotypes and Therapeutic Response. Metabolites. 2022 Apr 21;12(5):376
Rüddel H. et al. Adverse effects of delayed antimicrobial treatment and surgical source control in adults with sepsis: results of a planned secondary analysis of a cluster-randomized controlled trial. Crit Care 26, 51 (2022).
Codina M.S. and Zeitlinger M. Biomarkers Predicting Tissue Pharmacokinetics of Antimicrobials in Sepsis: A Review. Clin Pharmacokinet 2022
Hagel S. et al. Effect of therapeutic drug monitoring-based dose optimization of piperacillin/tazobactam on sepsis-related organ dysfunction in patients with sepsis: a randomized controlled trial. Intensive Care Med 48, 311–321 (2022).
Tiruvoipati R. et al. An Exploratory Analysis of the Association between Hypercapnia and Hospital Mortality in Critically Ill Patients with Sepsis. Ann Am Thorac Soc. 2022 Feb;19(2):245-254.
Rosengrave P. et al. Intravenous vitamin C administration to patients with septic shock: a pilot randomised controlled trial. Crit Care 2022;26:26 –
Lazzaro A. et al. The Interplay between Host Defense, Infection, and Clinical Status in Septic Patients: A Narrative Review. Int J Mol Sci. 2022 Jan 12;23(2):803.
Osuchowski, M.F. et al. Minimum quality threshold in pre-clinical sepsis studies (MQTiPSS): an international expert consensus initiative for improvement of animal modeling in sepsis. ICMx 6, 26 (2018).
Coopersmith, C.M. et al. Surviving Sepsis Campaign: Research Priorities for Sepsis and Septic Shock. Crit Care Med. 2018 Aug;46(8):1334-1356.
Surviving Sepsis Campaign
The Surviving Sepsis Campaign (SSC) is a partnership of the European Society of Intensive Care Medicine and the Society of Critical Care Medicine.
It was started in 2002 with several aims including the development of guidelines for diagnosis, treatment and post-ICU care of sepsis and a reduction of mortality from sepsis.
Updated Adult Guidelines – October 2021
The updated adult sepsis guidelines represent input from a diverse panel of 60 experts and a survey of more than 800 intensivists from more than 30 countries. The guidelines recommend involving patients and their families in goals-of-care discussions to treat the long-term effects of sepsis.
COVID-19 guidelines – January 2021
The Surviving Sepsis Campaign (SSC) has updated the previously released Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19).
The panel issued nine statements related to ICU patients with severe or critical COVID-19. Several of the original recommendations remain current.
Amongst the nine updates for treating severe or critical COVID-19 patients, the panel strongly recommends using systemic corticosteroids and venous thromboprophylaxis, and strongly recommends against using hydroxychloroquine. In addition, the panel suggests using dexamethasone (compared with other corticosteroids) and suggests against using convalescent plasma outside clinical trials. The SSC COVID-19 panel suggests using remdesivir in nonventilated patients with severe COVID-19 and suggests against starting remdesivir in patients with critical COVID-19 outside clinical trials. Because of insufficient evidence, the panel was not able to issue recommendations on the use of awake prone positioning or empiric therapeutic anticoagulation.
- Concise Recommendations Tables: First Update – Coronavirus Guidelines Recommendations Table
- Infographic 1 | Infographic 2 | Infographic 3 | Video
Access the original guidelines, published in June 2020, here.
Bundle – 2018
Levy, M.M. et al. The Surviving Sepsis Campaign Bundle: 2018 update. Intensive Care Med 44, 925–928 (2018). https://doi.org/10.1007/s00134-018-5085-0
IMPROVING THE PREVENTION, DIAGNOSIS AND MANAGEMENT OF SEPSIS
On May 26th the World Health Organisation held its 70th assembly in Geneva, Switzerland. During this gathering, 194 United Nations member states voted to affirm a resolution implementing steps to reduce the human and economic burden of sepsis. Outgoing Director-General Dr Margaret Chan through this resolution drew attention to these important actions:
- Publish a report on sepsis and its global consequences by the end of 2018;
- Draw attention to the public impact of sepsis;
- Collaborate with other organisations & relevant stakeholders in enhancing access to quality, safe, efficacious and affordable types of treatments of sepsis, and infection prevention and control; and
- Report to the 2020 WHA on the implementation of this resolution.
The European Society of Intensive Care Medicine and the Society of Critical Care Medicine through the Surviving Sepsis Campaign, will be assessing steps the Campaign will take to contribute and support these vitally important efforts. Please share this resolution information amongst your colleagues at your hospital in acknowledgement that sepsis has now been officially recognised as a global challenge in which we all play an important role worldwide. Thank you all for your dedication to early identification and treatment, antibiotic stewardship and continued vigilance on behalf of the patients we serve.