CHESTSepsis

Sepsis

In brief: what’s new and notable in sepsis

Explore notable updates in sepsis, including research into the optimal timing of antibiotic administration, investigations into the prevalence and outcomes of sepsis among various patient populations, and a study into outcomes and predictors of mortality in patients with solid tumors and septic shock. Review insights from the Sepsis/Shock Section of CHEST’s Critical Care Network; watch a review of shock, sepsis, and hemodynamic monitoring from experts in the field; and read CHEST’s latest statements in support of optimal sepsis management.

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RESEARCH AND NEWS

Additional research in sepsis

News, notes, and opinions

RESOURCES

Build your sepsis medicine expertise

Sepsis research, news, and notes

Additional research in sepsis

Review other important research in sepsis selected by members of the Sepsis Resources Steering Committee, including studies exploring fluid management for sepsis-induced hypotension and investigations into the relationship between the timing of antibiotic administration and patient outcomes.

NEW ENGLAND JOURNAL OF MEDICINE

Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension

Restricting fluids in favor of early vasopressor does not pay. This multicenter study showed that prioritizing vasopressor over fluid resuscitation in adult patients with hypotensive sepsis in the ED did not decrease rates of 90-day mortality, mechanical ventilation, or renal replacement therapy, although one group did show an increase in ICU admissions. The study was halted at the second interim analysis for futility.

NEW ENGLAND JOURNAL OF MEDICINE

Restriction of Intravenous Fluid in ICU Patients With Septic Shock

In multicenter study of adult patients in the ICU receiving vasopressor therapy, restricting fluids showed no differences in 90-day mortality, serious adverse events, days alive without life support, and days alive out of the hospital compared with continuing fluids. These results support the findings of a recent systematic review and meta-analysis examining fluid volumes in the management of sepsis.

JAMA INTERNAL MEDICINE

Temporal Trends in Antimicrobial Prescribing During Hospitalization for Potential Infection and Sepsis

Does early use of broad-spectrum antibiotics increase antibiotic use and abuse in sepsis? This observational study showed that decreasing the time to administration was not associated with increases in overall antibiotic use, days of use, or the broadness of antimicrobial coverage. However, mortality and hospital length of stay did decrease with the earlier antibiotic timing.

JAMA SURGERY

Association Between Time to Source Control in Sepsis and 90-Day Mortality

Don’t forget source control in sepsis. In this observational cohort study of patients undergoing early (<6 hours) or late (6-36 hours) source control from sepsis onset, early source control was associated with a decreased odds for mortality. Compared with 6 hours, 90-day mortality with source control at 3 hours was reduced by 0.5%, but increased by 1% at 12 hours, 3% at 24 hours, and 5% at 36 hours.

SHOW ADDITIONAL RESEARCH IN SEPSIS

News, notes, and opinions in sepsis medicine

CRITICAL CARE NETWORK

Fluid Resuscitation – Back to BaSICS
Review new guideline updates and recent data on the appropriate timing, volume, and type of fluid resuscitation for patients with septic shock.

ADVOCACY

SEP-1 protocol to manage severe sepsis and septic shock
Read the letter CHEST and the Society of Critical Care Medicine issued to the National Quality Forum in support of the continued use of the SEP-1 quality measure, including research addressing the concerns of organizations advocating against renewing the measure.

CHEST PHYSICIAN®

Patients need Sep-1: Why don’t some doctors like it?
In this editorial, former CHEST President, Steven Q. Simpson, MD, FCCP, highlights key aspects of the SEP-1 measure and data on how its use positively impacts patient care.

CRITICAL CARE NETWORK

SEP-1 measure saves lives, let’s not debate!
Members of CHEST’s Sepsis/Shock Section review findings from a 2022 study into the efficacy of the SEP-1 measure and provide context for the controversy around its use.

CHEST PHYSICIAN®

Looking to the future of physiologically informed sepsis resuscitation: The role of dynamic fluid-responsive measurement
Explore findings from three sepsis studies evaluating early, goal-directed therapy as well as additional research into the efficacy of current fluid resuscitation practices.

THOUGHT LEADER BLOG

Septic Shock: Moving in the Right Direction
Steven Q. Simpson, MD, FCCP, reviews the findings of a study into incidence and mortality trends among patients with septic shock over 10 years at 27 US academic medical centers.

STEERING COMMITTEE

The mission of the Sepsis Resources Steering Committee—made up of leaders from the CHEST membership with a clinical expertise in sepsis management—is to curate a collection of resources designed to help guide and inform the care clinicians deliver to patients with sepsis. This committee aims to provide clinicians with the latest guidance and research to help enhance sepsis prevention practices and improve patient outcomes.

Steven Q. Simpson, MD, FCCP, Chair

Steven Q. Simpson,
MD, FCCP, Chair

CHEST President, 2020-2021

Christopher Carroll, MD, FCCP

Christopher Carroll,
MD, FCCP

Board of Regents, Regent-at-Large, and Critical Care Network, Chair

Angel Coz Yataco, MD, FCCP

Angel Coz Yataco,
MD, FCCP

Council of Networks, Chair

Alice Gallo De Moraes, MD, FCCP

Alice Gallo De Moraes,
MD, FCCP

Mechanical Ventilation and Airways Management Section, Member

Ryan Maves, MD, FCCP

Ryan Maves,
MD, FCCP

Disaster Response and Global Health Section, Chair

H. Bryant Nguyen, MD, MS

H. Bryant Nguyen,
MD, MS

Sepsis/Shock Section, Chair

Katie Pendleton, MD, FCCP

Katie Pendleton,
MD, FCCP

Sepsis/Shock Section, Vice-Chair

Marcos Restrepo, MD, PhD, FCCP

Marcos Restrepo,
MD, PhD, FCCP

Chest Infections and Disaster Response Network, Chair

These resources were supported by Grant/Cooperative Agreement Number 5 NU50CK000604-02-00 from the Department of Health and Human Services, Centers for Disease Control and Prevention. The contents are solely the responsibility of the authors and do not necessarily represent the official views of the Department of Health and Human Services, Centers for Disease Control and Prevention.