Intensive Care Med (2010) 36:222–231 DOI 10.1007/s00134-009-1738-3 O R I G I N A L Mitchell M. Levy R. Phillip Dellinger Sean R. Townsend Walter T. Linde-Zwirble John C. Marshall Julian Bion Christa Schorr Antonio Artigas Graham Ramsay Richard Beale Margaret M. Parker Herwig Gerlach Konrad Reinhart Eliezer Silva Maurene Harvey Susan Regan Derek C. Angus Received: 26 May 2009 Accepted: 27 November 2009 Published online: 13 January 2010 Copyright jointly hold by Springer and ESICM 2010 On behalf of the Surviving Sepsis Campaign. This article is being simultaneously published in Intensive Care Medicine and Critical Care Medicine. This article is discussed in the editorial available at: doi:10.1007/s00134-009-1737-4. Electronic supplementary material The online version of this article (doi:10.1007/s00134-009-1738-3) contains supplementary material, which is available to authorized users. M. M. Levy ()) Division of Pulmonary, Sleep and Critical Care Medicine, Brown University School of Medicine, Rhode Island Hospital, 593 Eddy St., Providence, RI 02903, USA e-mail: Mitchell_Levy@brown.edu R. P. Dellinger C. Schorr Department of Medicine, University of Medicine and Dentistry of New Jersey, Cooper University Hospital, Camden, NJ, USA The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis S. R. Townsend Division of Pulmonary, Allergy, and Critical Care Medicine, University of Massachusetts Medical School, Worcester, MA, USA S. R. Townsend The Institute for Healthcare Improvement, Cambridge, MA, USA W. T. Linde-Zwirble ZD Associates LLC, Perkasie, PA, USA J. C. Marshall Department of Surgery, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, University of Toronto, Toronto, ON, Canada J. Bion University Department of Anaesthesia and Intensive Care Medicine, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK A. Artigas Critical Care Centre, Sabadell Hospital, CIBER Enfermedades Respiratorias, Autonomous University of Barcelona, Barcelona, Spain G. Ramsay Mid Essex Hospital Services NHS Trust, London, UK R. Beale Guy’s and St. Thomas’ NHS Foundation Trust, St. Thomas’ Hospital, London, UK M. M. Parker Department of Medicine, Stony Brook University, Stony Brook, NY, USA H. Gerlach Vivantes-Klinikum Neukoelln, Berlin, Germany K. Reinhart Clinic for Anesthesiology and Intensive Care, Jena, Germany E. Silva Hospital Israelita Albert Einstein, Sao Paolo, Brazil M. Harvey Consultants in Critical Care, Inc., Glenbrook, NV, USA S. Regan Department of Medicine, Harvard Medical School and General Medicine Division, Massachusetts General Hospital, Boston, MA, USA D. C. Angus CRISMA Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA Abstract Objective: The Surviv- ing Sepsis Campaign (SSC or ‘‘the Campaign’’) developed guidelines for management of severe sepsis and septic shock. A performance improvement initiative targeted