%0 Journal Article
%T Surviving sepsis: going beyond the guidelines
%A Paul E Marik
%J Annals of Intensive Care
%D 2011
%I Springer
%R 10.1186/2110-5820-1-17
%X Sepsis is among the most common reasons for admission to intensive care units (ICUs) throughout the world. During the past two decades, the incidence of sepsis in the United States has tripled and is now the tenth leading cause of death. In the United States alone, approximately 750,000 cases of sepsis occur each year, at least 225,000 of which are fatal [1,2]. Septic patients are generally hospitalized for extended periods, rarely leaving the ICU before 2-3 weeks. Despite the use of antimicrobial agents and advanced life-support, the case fatality rate for patients with sepsis has remained between 20% and 30% during the past 2 decades [1,2].The Surviving Sepsis Campaign (SSC) is a global effort to improve the care of patients with severe sepsis and septic shock. The campaign was launched by the Society of Critical Care Medicine, the European Society of Intensive Care Medicine and the International Sepsis Forum in 2002. The first Surviving Sepsis Campaign Guidelines were published in Critical Care Medicine in 2004 and included 52 recommendations [3]. Ely Lily and Company and Edwards Life Sciences sponsored the guideline process, raising concerns about the integrity of the guidelines [4]. Furthermore, it appeared that the guideline implementation process was part of the marketing strategy for the Eli Lilly Company. The Surviving Sepsis Campaign Guidelines were updated in 2008, and although free of corporate sponsorship and somewhat broader in scope (85 recommendations), the core recommendation's remained largely unchanged [5].These core recommendations were principally based on the results of a small, single-center study by Rivers et al. (Early Goal-Directed Therapy [EGDT]) whose validity has been recently under increasing scrutiny [6,7]. It is important to note that the majority of recommendations in both sets of guidelines were based on the lowest level of scientific evidence (Grade E - uncontrolled studies, case series and expert opinion). Barochia and colleagues
%U http://www.annalsofintensivecare.com/content/1/1/17