Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016
Authors: Rhodes Andrew , Evans Laura E. , Alhazzani Waleed , Levy Mitchell M. , Antonelli Massimo , Ferrer Ricard , Kumar Anand , Sevransky Jonathan E. , Sprung Charles L. , Nunnally Mark E. , Rochwerg Bram , Rubenfeld Gordon D. , Angus Derek C. , Annane Djillali , Beale Richard J. , Bellinghan Geoffrey J. , Bernard Gordon R. , Chiche Jean-Daniel , Coopersmith Craig , De Backer Daniel P. , French Craig J. , Fujishima Seitaro , Gerlach Herwig , Hidalgo Jorge Luis , Hollenberg Steven M. , Jones Alan E. , Karnad Dilip R. , Kleinpell Ruth M. , Koh Younsuck , Lisboa Thiago Costa , Machado Flavia R. , Marini John J. , Marshall John C. , Mazuski John E. , McIntyre Lauralyn A. , McLean Anthony S. , Mehta Sangeeta , Moreno Rui P. , Myburgh John , Navalesi Paolo , Nishida Osamu , Osborn Tiffany M. , Perner Anders , Plunkett Colleen M. , Ranieri Marco , Schorr Christa A. , Seckel Maureen A. , Seymour Christopher W. , Shieh Lisa , Shukri Khalid A. , Simpson Steven Q. , Singer Mervyn , Thompson B. Taylor , Townsend Sean R. , Van der Poll Thomas , Vincent Jean-Louis , Wiersinga W. Joost , Zimmerman Janice L. , Dellinger R. Phillip 
Published: January 2017

Objective:
To provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012.”

Design:
A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development.

Methods:
The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Population, intervention, comparison, and outcomes (PICO) questions were reviewed and updated as needed, and evidence profiles were generated. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable.

Results:
The Surviving Sepsis Guideline panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions.

Conclusions:
Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.