1Department of Surgery and Emory Critical Care Center, Emory University, Atlanta, GA, USA.2Chirec Hospitals, Université Libre de Bruxelles, Brussels, Belgium.3Department of Pediatrics, Cohen Children’s Medical center, Northwell Health, New Hyde Park, NY and the Feinstein Institute for Medical Research/Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, USA.4Intensive Care Department, Vall d’Hebron University Hospital; Shock, Organ Dysfunction and Resuscitation (SODIR) Research Group, Vall d’Hebron Institut de Recerca, Barcelona, Spain.5Rush University Medical Center, Chicago, IL, USA.6Universidade Federal de São Paulo, Sao Paulo, Brazil.7Department of Medicine, Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Grady Memorial Hospital and Emory Critical Care Center, Emory University, Atlanta, GA, USA.8Multidisciplinary Intensive Care Research Organization (MICRO), Department of Intensive Care Medicine, St. James’s University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland.9New York University School of Medicine, New York, NY, USA.10Department of Anesthesiology and Intensive Care Medicine, Fondazione Policlinico Universitario A.Gemelli-Università Cattolica del Sacro Cuore, Rome, Italy.11Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Bellevue Hospital Center and New York University School of Medicine, New York, NY, USA.12University of California, San Francisco, San Francisco, California, USA.13Consultant Intensivist, Deenanath Mangeshkar Hospital and Research center, Pune, India.14Department of Intensive Care Medicine, University Medical Center Utrecht, Utrecht University, the Netherlands.15Alpert Medical School at Brown University, Rhode Island Hospital, Providence, Rhode Island, USA.16Department of Adult Critical Care, St. George’s University Hospitals NHS Foundation Trust and St George’s University of London, London, UK.
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Objective:To identify research priorities in the management, epidemiology, outcome and underlying causes of sepsis and septic shock.Design:A consensus committee of 16 international experts representing the European Society of Intensive Care Medicine and Society of Critical Care Medicine was convened at the annual meetings of both societies. Subgroups had teleconference and electronic-based discussion. The entire committee iteratively developed the entire document and recommendations.Methods:Each committee member independently gave their top five priorities for sepsis research. A total of 88 suggestions (Supplemental Table 1, Supplemental Digital Content 2, http://links.lww.com/CCM/D636) were grouped into categories by the committee co-chairs, leading to the formation of seven subgroups: infection, fluids and vasoactive agents, adjunctive therapy, administration/epidemiology, scoring/identification, post-intensive care unit, and basic/translational science. Each subgroup had teleconferences to go over each priority followed by formal voting within each subgroup. The entire committee also voted on top priorities across all subgroups except for basic/translational science.Results:The Surviving Sepsis Research Committee provides 26 priorities for sepsis and septic shock. Of these, the top six clinical priorities were identified and include the following questions: 1) can targeted/personalized/precision medicine approaches determine which therapies will work for which patients at which times?; 2) what are ideal endpoints for volume resuscitation and how should volume resuscitation be titrated?; 3) should rapid diagnostic tests be implemented in clinical practice?; 4) should empiric antibiotic combination therapy be used in sepsis or septic shock?; 5) what are the predictors of sepsis long-term morbidity and mortality?; and 6) what information identifies organ dysfunction?Conclusions:While the Surviving Sepsis Campaign guidelines give multiple recommendations on the treatment of sepsis, significant knowledge gaps remain, both in bedside issues directly applicable to clinicians, as well as understanding the fundamental mechanisms underlying the development and progression of sepsis. The priorities identified represent a roadmap for research in sepsis and septic shock.