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Article Dans Une Revue Intensive Care Medicine Année : 2020

Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children

Scott L. Weiss
  • Fonction : Auteur
Mark J. Peters
  • Fonction : Auteur
Waleed Alhazzani
  • Fonction : Auteur
Michael S. D. Agus
  • Fonction : Auteur
Heidi R. Flori
  • Fonction : Auteur
David P. Inwald
  • Fonction : Auteur
Simon Nadel
  • Fonction : Auteur
  • PersonId : 972881
Luregn J. Schlapbach
  • Fonction : Auteur
Robert C. Tasker
  • Fonction : Auteur
Andrew C. Argent
  • Fonction : Auteur
Joe Brierley
  • Fonction : Auteur
Joseph Carcillo
  • Fonction : Auteur
Enitan D. Carrol
  • Fonction : Auteur
Christopher L. Carroll
  • Fonction : Auteur
Ira M. Cheifetz
  • Fonction : Auteur
Karen Choong
  • Fonction : Auteur
Jeffry J. Cies
  • Fonction : Auteur
Andrea T. Cruz
  • Fonction : Auteur
Daniele de Luca
  • Fonction : Auteur
Akash Deep
  • Fonction : Auteur
Saul N. Faust
  • Fonction : Auteur
Claudio Flauzino de Oliveira
  • Fonction : Auteur
Mark W. Hall
  • Fonction : Auteur
Paul Ishimine
  • Fonction : Auteur
Etienne Javouhey
  • Fonction : Auteur
Koen F. M. Joosten
  • Fonction : Auteur
Poonam Joshi
  • Fonction : Auteur
Oliver Karam
  • Fonction : Auteur
Martin C. J. Kneyber
  • Fonction : Auteur
Joris Lemson
  • Fonction : Auteur
Graeme Maclaren
  • Fonction : Auteur
Nilesh M. Mehta
  • Fonction : Auteur
Morten Hylander Møller
  • Fonction : Auteur
Christopher J. L. Newth
  • Fonction : Auteur
Trung C. Nguyen
  • Fonction : Auteur
Akira Nishisaki
  • Fonction : Auteur
Mark E. Nunnally
  • Fonction : Auteur
Margaret M. Parker
  • Fonction : Auteur
Raina M. Paul
  • Fonction : Auteur
Adrienne G. Randolph
  • Fonction : Auteur
Suchitra Ranjit
  • Fonction : Auteur
Lewis H. Romer
  • Fonction : Auteur
Halden F. Scott
  • Fonction : Auteur
Lyvonne N. Tume
  • Fonction : Auteur
Judy T. Verger
  • Fonction : Auteur
Eric A. Williams
  • Fonction : Auteur
Joshua Wolf
  • Fonction : Auteur
Hector R. Wong
  • Fonction : Auteur
Jerry J. Zimmerman
  • Fonction : Auteur
Niranjan Kissoon
  • Fonction : Auteur

Résumé

OBJECTIVES: To develop evidence-based recommendations for clinicians caring for children (including infants, school-aged children, and adolescents) with septic shock and other sepsis-associated organ dysfunction. DESIGN: A panel of 49 international experts, representing 12 international organizations, as well as three methodologists and three public members was convened. Panel members assembled at key international meetings (for those panel members attending the conference), and a stand-alone meeting was held for all panel members in November 2018. A formal conflict-of-interest policy was developed at the onset of the process and enforced throughout. Teleconferences and electronic-based discussion among the chairs, co-chairs, methodologists, and group heads, as well as within subgroups, served as an integral part of the guideline development process. METHODS: The panel consisted of six subgroups: recognition and management of infection, hemodynamics and resuscitation, ventilation, endocrine and metabolic therapies, adjunctive therapies, and research priorities. We conducted a systematic review for each Population, Intervention, Control, and Outcomes question to identify the best available evidence, statistically summarized the evidence, and then assessed the quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. We used the evidence-to-decision framework to formulate recommendations as strong or weak, or as a best practice statement. In addition, "in our practice" statements were included when evidence was inconclusive to issue a recommendation, but the panel felt that some guidance based on practice patterns may be appropriate. RESULTS: The panel provided 77 statements on the management and resuscitation of children with septic shock and other sepsis-associated organ dysfunction. Overall, six were strong recommendations, 49 were weak recommendations, and nine were best-practice statements. For 13 questions, no recommendations could be made; but, for 10 of these, "in our practice" statements were provided. In addition, 52 research priorities were identified. CONCLUSIONS: A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations. Despite this challenge, these recommendations regarding the management of children with septic shock and other sepsis-associated organ dysfunction provide a foundation for consistent care to improve outcomes and inform future research.

Dates et versions

hal-02476322 , version 1 (12-02-2020)

Identifiants

Citer

Scott L. Weiss, Mark J. Peters, Waleed Alhazzani, Michael S. D. Agus, Heidi R. Flori, et al.. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Medicine, 2020, 46 (Suppl 1), pp.10--67. ⟨10.1007/s00134-019-05878-6⟩. ⟨hal-02476322⟩
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