Surviving Sepsis Campaign: Research Opportunities for Infection and Blood Purification Therapies.

• Type of Material: Article
• Authors: Ignacio Martin-Loeches, St. James’s Hospital; Mark E. Nunnally, New York University; Judith Hellman, University of California San Francisco; Ishaq Lat, Shirley Ryan Abilitylab; Gregory Martin, Emory University; Sameer Jog, Deenanath Mangeshkar Hospital; Jozef Kesecioglu, University Medical Center Utrecht; Daniel De Backer, Université Libre de Bruxelles; Craig Coopersmith, Emory University
• Language: English
• Date: 2021-09
• Publisher: Society of Critical Care Medicine
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1097/CCE.0000000000000511
• Title of Journal or Parent Work: Crit Care Explor
• Volume: 3
• Issue: 9
• Start Page: e0511
• End Page: e0511
• Grant/Funding Information: Dr. Martin-Loeches received honoraria from Merck Sharp & Dohme, Gilead, and Aspen. Dr. Nunnally is Treasurer of the Society of Critical Care Anesthesiologists. Dr. Martin is the President of the Society of Critical Care Medicine. His institution received funding from the National Institutes of Health, Biomedical Advance Research and Development Authority, and Marcus Foundation, and he is a clinical research consultant to Regeneron and Beckman-Coulter. Dr. Kesecioglu is immediate past President of the European Society of Intensive Care Medicine. Dr. De Backer is past President of the European Society of Intensive Care Medicine and has received consulting fees from Fresenius Kabi. Dr. Coopersmith is past President of the Society of Critical Care Medicine. The remaining authors have disclosed that they do not have any conflicts of interest.
• Keywords: ventilator-associated pneumonia; septic shock; intensive care unit; infection; sepsis
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Patients with infection can develop sepsis, and their mortality can be high. An important aspect in the treatment of sepsis is adequate management of the infection. DATA SOURCES: Using a modified Delphi approach, the Surviving Sepsis Campaign research committee recently published a series of 26 priorities for sepsis and septic shock. STUDY SELECTION: Task force members with specific expertise were tasked with generating expanded reviews for all infection questions and a subset of adjunctive therapy questions from the larger list of sepsis priorities. Each question was addressed by one of the six task force members. DATA EXTRACTION: In-depth reviews were then edited by the group as a whole, with added input from the committee cochairs. DATA SYNTHESIS: Six questions were addressed: 1) should empiric antibiotic combination therapy be used in sepsis or septic shock? 2) does optimization of antimicrobial pharmacokinetics and pharmacodynamics impact patient outcomes in sepsis? 3) should viral reactivation resulting from sepsis-induced immunosuppression be treated with antiviral therapy in critically ill septic patients? 4) should rapid diagnostic tests be implemented in clinical practice? 5) what is the role of lung-protective ventilation in sepsis patients without acute respiratory distress syndrome? and 6) how do we determine the efficacy of "blood purification" therapies such as endotoxin absorbers, cytokine absorbers, and plasmapheresis. CONCLUSIONS: The research committee members for the Surviving Sepsis Campaign aimed to explore research questions in order to provide existing evidence and highlight areas of uncertainty and future directions.