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International Guidelines for Management of Sepsis and Septic Shock: 2016

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International Guidelines for Management of Sepsis and Septic Shock: 2016 Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016 Andrew Rhodes, MB BS, MD(Res) (Co-chair)1; Laura E. Evans, MD, MSc, FCCM (Co-chair)2; Waleed Alhazzani, MD, MSc, FRCPC (methodology chair) 3; Mitchell M. Levy, MD, MCCM4; Massimo Antonelli, MD5; Ricard Ferrer, MD, PhD6; Anand Kumar, MD, FCCM7; Jonathan E. Sevransky, MD, FCCM8; Charles L. Sprung, MD, JD, MCCM9; Mark E. Nunnally, MD, FCCM2; Bram Rochwerg, MD, MSc (Epi)3; Gordon D. Rubenfeld, MD (conflict of interest chair)10; Derek C. Angus, MD, MPH, MCCM11; Djillali Annane, MD12; Richard J. Beale, MD, MB BS13; Geoffrey J. Bellinghan, MRCP14; Gordon R. Bernard, MD15; Jean-Daniel Chiche, MD16; Craig Coopersmith, MD, FACS, FCCM8; Daniel P. De Backer, MD, PhD17; Craig J. French, MB BS18; Seitaro Fujishima, MD19; Herwig Gerlach, MBA, MD, PhD20; Jorge Luis Hidalgo, MD, MACP, MCCM21; Steven M. Hollenberg, MD, FCCM22; Alan E. Jones, MD23; Dilip R. Karnad, MD, FACP24; Ruth M. Kleinpell, PhD, RN-CS, FCCM25; Younsuk Koh, MD, PhD, FCCM26; Thiago Costa Lisboa, MD27; Flavia R. Machado, MD, PhD28; John J. Marini, MD29; John C. Marshall, MD, FRCSC30; John E. Mazuski, MD, PhD, FCCM31; Lauralyn A. McIntyre, MD, MSc, FRCPC32; Anthony S. McLean, MB ChB, MD, FRACP, FJFICM33; Sangeeta Mehta, MD34; Rui P. Moreno, MD, PhD35; John Myburgh, MB ChB, MD, PhD, FANZCA, FCICM, FAICD36; Paolo Navalesi, MD37; Osamu Nishida, MD, PhD38; Tiffany M. Osborn, MD, MPH, FCCM31; Anders Perner, MD39; Colleen M. Plunkett25; Marco Ranieri, MD40; Christa A. Schorr, MSN, RN, FCCM22; Maureen A. Seckel, CCRN, CNS, MSN, FCCM41; Christopher W. Seymour, MD42; Lisa Shieh, MD, PhD43; Khalid A. Shukri, MD44; Steven Q. Simpson, MD45; Mervyn Singer, MD46; B. Taylor Thompson, MD47; Sean R. Townsend, MD48; Thomas Van der Poll, MD49; Jean-Louis Vincent, MD, PhD, FCCM50; W. Joost Wiersinga, MD, PhD51, Janice L. Zimmerman, MD, MACP, MCCM52; R. Phillip Dellinger, MD, MCCM22 1St. George’s Hospital London, England, United Kingdom. 9Hadassah Hebrew University Medical Center Jerusalem, Israel. 2New York University School of Medicine New York, NY. 10Sunnybrook Health Sciences Centre Toronto, Ontario, Canada. 3McMaster University Hamilton, Ontario, Canada. 11 University of Pittsburgh Critical Care Medicine CRISMA Laboratory 4Brown University School of Medicine Providence, RI. Pittsburgh, PA. 12 5Instituto di Anestesiologia e Rianimazione, Università Cattolica del Sacro Hospital Raymond Poincare Garches, France. Cuore, Rome, Italy. 13Saint Thomas Hospital London, England, United Kingdom. 6Vall d’Hebron University Hospital Barcelona, Spain. 14University College London Hospitals London, England, United Kingdom. 7University of Manitoba Winnipeg, Manitoba, Canada. 15Vanderbilt University Medical Center Nashville, TN. 8Emory University Hospital Atlanta, GA. 16Service de Reanimation Medicale Paris, France. Copyright © 2017 by the Society of Critical Care Medicine and the 17CHIREC Hospitals Braine L’Alleud, Belgium. European Society of Intensive Care Medicine 18Western Hospital Victoria, Australia. DOI: 10.1097/CCM.0000000000002255 19Keio University School of Medicine, Tokyo, Japan. Critical Care Medicine www.ccmjournal.org 1 Copyright © 2017 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Rhodes et al 20Vivantes-Klinikum Neukölln, Berlin, Germany. Society of Paediatric and Neonatal Intensive Care, European Society for 21 Karl Heusner Memorial Hospital Belize Healthcare Partners Belize City, Emergency Medicine, Federación Panamericana e Ibérica de Medicina Belize. Crítica y Terapia Intensiva, Sociedad Peruana de Medicina Intensiva, Shock Society, Sociedad Argentina de Terapia Intensiva, World Federation of 22 Cooper Health System Camden, NJ. Pediatric Intensive and Critical Care Societies. 23 University of Mississippi Medical Center Jackson, MS. Dr. Rhodes is a past-president of the European Society of Intensive Care 24Jupiter Hospital Thane, India. Medicine. Dr. Levy received consulting fees from ImmuneExpress. 25Rush University Medical Center Chicago, IL. Dr. Antonelli received funding from Pfizer, MSD, Cubist, Maquet, Drager, Toray, and Baxter; he participates in ESA and SIAARTI. Dr. Kumar received 26 ASAN Medical Center University of Ulsan College of Medicine Seoul, scientific consulting fees from Baxter, Isomark, and Opsonix on diagnostic South Korea. technologies; he received grant funding from GSK in the area of influenza. 27Hospital de Clinicas de Porto Alegre Porto Alegre, Brazil. Dr. Ferrer Roca received funding from Estor, MSD, Astra-Zeneca, and Grifols 28Federal University of Sao Paulo Sao Paulo, Brazil. and participates in ESICM and SEMICYUC. Dr. Sevransky is an Associate Editor of Critical Care Medicine. Dr. Sprung received funding from Asahi 29 Regions Hospital St. Paul, MN. Kasei Pharma America Corporation (consultant, Data Safety and Monitoring 30Saint Michael’s Hospital Toronto, Ontario, Canada. Committee) and LeukoDx Ltd. (consultant; PI, research study on biomarkers 31Washington University School of Medicine St. Louis, MO. of sepsis). He participates in International Sepsis Forum (board member). Dr. Angus received funding Ferring Inc (consulting fees for serving on the Trial 32 Ottawa Hospital Ottawa, Ontario, Canada. Steering Committee of a Phase 2/3 trial of selepressin for septic shock), and 33 Nepean Hospital, University of Sydney Penrith, New South Wales, Aus- from Ibis and Genmark (both for consulting fees regarding diagnostic strate- tralia. gies in sepsis). He is a contributing editor for JAMA, has conducted commit- 34Mount Sinai Hospital Toronto, Ontario, Canada. tee membership work for the American Thoracic Society, and has contributed to an IOM workshop on regulatory science. Dr. Angus provided expert testi- 35 UCINC, Centro Hospitalar de Lisboa Central, Lisbon, Portugal. mony in medical malpractice cases. Dr. Beale’s institution received funding 36University of New South Wales, Sydney, New South Wales, Australia. from Roche (consulting regarding sepsis diagnostics); he received funding 37Università dellla Magna Graecia Catanzaro, Italy. from Quintiles (consulting on routes to license for a potential ARDS therapy); he participates in the UK National Institute for Clinical and Healthcare Excel- 38 Fujita Health University School of Medicine, Toyoake, Aich, Japan. lence Sepsis Guideline Development Group; he has served as an expert 39Rigshospitalet Copenhagen, Denmark. witness, disclosing that he is approached from time to time regarding expert 40Università Sapienza, Rome, Italy. witness testimony for ICU cases, which may involve patients who have sep- sis and the testimony relates to generally accepted current standards of care, 41 Christiana Care Health Services Newark, DE. and formal guidance, as it currently pertains within the UK. Dr. Bellingan 42University of Pittsburgh School of Medicine Pittsburgh, PA. received funding from Faron (research into interferon in lung injury) and 43Stanford University School of Medicine Stanford, CA. Athersys (stem cells in lung injury). Dr. Chiche received funding for consult- ing activities and honoraria for lectures from GE Healthcare, monitoring and 44 Kaust Medical Services Thuwal, Saudi Arabia. IT solutions; he received funding from Nestlé Healthsciences (consulting 45University of Kansas Medical Center Kansas City, KS. activities and honorarium), and from Abbott diagnostics (consulting activi- 46 Wolfson Institute of Biomedical Research London, England, United ties). Dr. Coopersmith is on the fellowship committee of Surgical Infection Kingdom. Society. Dr. De Backer received funding from Edwards Healthcare, Frese- nius Kabi, and Grifols. Dr. Dellinger provided expert testimony for alleged 47 Massachusetts General Hospital Boston, MA. malpractice in critical care. Dr. French participates in Australian and New 48California Pacific Medical Center San Francisco, CA. Zealand Intensive Care Society Clinical Trials Group (chair). Dr. Fujishima 49University of Amsterdam Amsterdam, Netherlands. participates in the Japanese Association for Acute Medicine (board member, Japanese Guidelines for the management of sepsis) and Japanese Respira- 50 Erasmé University Hospital Brussels, Belgium. tory Society (board member, Japanese Guidelines for the management of 51University of Amsterdam, Amsterdam, Netherlands. ARDS); he received funding from Asahi Kasei Co (lecture). Dr. Hollenberg 52Houston Methodist Hospital, Houston, TX. participates in the ACC/AHA PCI and Heart Failure guidelines, CHEST edi- torial board, ACCP-SEEK, and CHEST CV Network chair. Dr. Jones partici- Corresponding author: Andrew Rhodes, St. George’s Hospital, pates in ACEP and SAEM, and has served as an expert witness on various London, United Kingdom. Email: [email protected] cases. Dr. Karnad received funding from Quintiles Cardiac Safety Services Supplemental digital content is available for this article. Direct URL cita- (consultant) and from Bharat Serum and Vaccines Ltd (consultant). He par- tions appear in the printed text and are provided in the HTML and PDF ticipates in the Indian Society of Critical Care Medicine and the Association versions of this on the journal’s Web site of Physicians of India. Dr. Kleinpell participates in Critical Care Medicine This article is being simultaneously published in Critical Care Medicine American Board of Internal Medicine (board member), Institute of Medicine and Intensive Care Medicine. of Chicago (board member), and the Commission on Collegiate Nursing Education (board member). Dr.
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