The Surviving Sepsis Campaign, an international organisation dedicated to the analysis of evidence in the treatment of sepsis, issued recommendations in 2012 to guide clinicians through the care of patients with severe sepsis and septic shock.
The main recommendations are the implementation of goal-directed therapy during the first six hours of resuscitation and the administration of intravenous antibiotics within one hour of a diagnosis of septic shock or severe sepsis without septic shock.
Crystalloid fluids should the first choice for fluid resuscitation, and the use of corticosteroids should be avoided in the absence of shock; albumin is suggested for resuscitation procedures when patients need large amounts of crystalloids.
Other recommendations not supported by robust data include the use of conservative fluid approaches in adults with respiratory distress syndrome due to sepsis.
Screening and diagnosis are covered as well as antibiotic therapy, source control, and other general aspects to consider such as sedation, ventilation, and nutrition.
An individual section is dedicated to the management of severe sepsis in children. In addition, the concept of ‘bundles of care’ for resuscitation are introduced, which can potentially be used in assessments of quality of care in clinical practice.