Surviving sepsis Campaign: - International guidelines for management of severe sepsis and septic shock in pediatric:-2008
Date
2008-11-16
Authors
Dr. Abdulrazzaq Abu Mayyaleh
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
<p>Objective: to provide an update to the original Surviving Sepsis Campaign clinical management<br />
guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and septic shock," published in 2004.</p>
<p>Design: we used the grades of Recommendation , Assessment, Development and Evaluation<br />
(GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendation. A strong recommendation:- Indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden,<br />
and cost) or clearly do not. Weak recommendations. Indicates that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in later level of quality of evidence.<br />
Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations.</p>
<p>Results: Recommendation specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C) and a recommendation against the use of recombinant activated protein C in children (1B).</p>
<p>Conclusions: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced- based 31 First International Faculty of Medicine Conference 2008 recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients. (Crit Care Med 2008; 36:296-327)</p>
<p>Objective: to provide an update to the original Surviving Sepsis Campaign clinical management<br /> guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and septic shock," published in 2004.</p> <p>Design: we used the grades of Recommendation , Assessment, Development and Evaluation<br /> (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendation. A strong recommendation:- Indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden,<br /> and cost) or clearly do not. Weak recommendations. Indicates that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in later level of quality of evidence.<br /> Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations.</p> <p>Results: Recommendation specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C) and a recommendation against the use of recombinant activated protein C in children (1B).</p> <p>Conclusions: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced- based 31 First International Faculty of Medicine Conference 2008 recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients. (Crit Care Med 2008; 36:296-327)</p>
<p>Objective: to provide an update to the original Surviving Sepsis Campaign clinical management<br /> guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and septic shock," published in 2004.</p> <p>Design: we used the grades of Recommendation , Assessment, Development and Evaluation<br /> (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendation. A strong recommendation:- Indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden,<br /> and cost) or clearly do not. Weak recommendations. Indicates that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in later level of quality of evidence.<br /> Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations.</p> <p>Results: Recommendation specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C) and a recommendation against the use of recombinant activated protein C in children (1B).</p> <p>Conclusions: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced- based 31 First International Faculty of Medicine Conference 2008 recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients. (Crit Care Med 2008; 36:296-327)</p>