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

A review article published in the September 2021 issue of Critical Care Explorations by members of the Surviving Sepsis Campaign Research Committee. 

Patients admitted to an ICU due to sepsis and with the need of organ support have a high mortality rate. The Surviving Sepsis Campaign (SSC) has previously made very specific recommendations to be implemented to fight sepsis. Treatment of severe infections is a top priority of sepsis management. Recommendations from the SSC have been shown to improve outcome, following implementation. Despite the guidelines use of Grading of Recommendations, Assessment, Development, and Evaluation methodology, some recommendations from SSC have proven to be controversial due to either conflicting data or concerns from some inadequate data to drive recommendations. One example is that the SSC strongly recommends that empirical broad-spectrum antibiotics should be given within 1 hour of sepsis identification to patients with septic shock and also to those with sepsis and without shock. One of the main concerns voiced regarding this recommendation is the lack of randomized clinical trials in support of it. However, data from multiple observational studies and meta-analyses suggest that early antibiotic administration is associated with improved survival even among patients without shock. This and other controversies highlight the need for further research in multiple areas related to sepsis. Further, there are many questions in which inadequate data exist for SSC to yield a recommendation.

In an attempt to both drive clinical research and answer fundamental questions related to sepsis biology, the SSC created the SCC research committee to prioritize research needs. This led to the recent publication of 26 research priorities in sepsis and septic shock. In the present article, we expand upon six research questions in the SSC priority list related to both infection and adjunctive therapy to provide evidence and delineate areas of uncertainty and future directions.

Ignacio Martin-Loeches, MD, PhD, JFICMI

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Categories: Surviving Sepsis Campaign, Sepsis,
Content Type: Articles,