The Surviving Sepsis Campaign sepsis change bundles and clinical practice

The Surviving Sepsis Campaign (SSC) is an international effort to reduce mortality in severe sepsis and septic shock. The campaign included the creation of evidence-based guidelines sponsored and endorsed by 11 international organizations. From these guidelines, sepsis change bundles for initial resuscitation (6 hours) and management (24 hours) were created as a performance improvement tool. In this issue of Critical Care, Gao et al. have evaluated performance at their institution by using a close adaptation of the two SSC bundle sets and demonstrated an association between 100% compliance with the bundle elements and clinical outcome. The next step will be to demonstrate that the use of education and feedback for performance improvement will increase compliance and decrease mortality in the patient population in general

Arterial pressure optimization in the treatment of septic shock: a complex puzzle

Arterial pressure optimization in septic shock is a critical, yet poorly understood component of resuscitation. New data suggest that, during the routine management of patients with severe sepsis, there is no association between mean arterial pressure achieved and outcome as long as the mean arterial pressure is maintained at or above 70 mmHg. Although these data add important new evidence to our understanding of arterial pressure management, there are still many unanswered questions upon which future investigations should focus

Sepsis 2015: You say you wanted a revolution

Objectives: Understand current considerations for changing definitions of sepsis Understand what we should do in the early management of sepsis Understand the questions still to be answered in guiding early management of sepsis Know what’s going on in clinical trials in sepsis Overall Goals and Objectives: Following this activity, a participant should be able to: 1. Recognize recent advances and developments in Pulmonary Medicine & Critical Care and translate into clinical practice 2. Integrate perspectives of multiple disciplines into decision-making on behalf of patients through structured plans for patient care. 3. Develop areas for future research and discuss appropriate methods to address these needs. 4. Summarize and continually improve communications as a team, caring for Pulmonary/Critical Care patients. Slides only, no audio

Ethics roundtable: Using new, expensive drugs

Costly genetically engineered therapies, which threaten to cripple the health care industry economy and undermine the common good if applied indiscriminately, loom on the horizon. The spectrum of applicable candidates include moribund nursing home patients at the end of life. They will be fair game for therapy that will ultimately send them back to nursing homes to return later with the same condition. 'Quality of life' assessments that limit patient autonomy may be forced as a result. Discussants from South Africa, New Zealand, and the USA suggest methods to deal with this issue in a just and ethical framework