Skip to main content
Erschienen in: Intensive Care Medicine 9/2017

12.05.2017 | Research Agenda

The intensive care medicine research agenda on septic shock

verfasst von: Anders Perner, Anthony C. Gordon, Derek C. Angus, Francois Lamontagne, Flavia Machado, James A. Russell, Jean-Francois Timsit, John C. Marshall, John Myburgh, Manu Shankar-Hari, Mervyn Singer

Erschienen in: Intensive Care Medicine | Ausgabe 9/2017

Einloggen, um Zugang zu erhalten

Abstract

Septic shock remains a global health challenge with millions of cases every year, high rates of mortality and morbidity, impaired quality of life among survivors and relatives, and high resource use both in developed and developing nations. Care and outcomes are improving through organisational initiatives and updated clinical practice guidelines based on clinical research mainly carried out by large collaborative networks. This progress is likely to continue through the collaborative work of the established and merging trials groups in many parts of the world and through refined trial methodology and translational work. In this review, international experts summarize the current position of clinical research in septic shock and propose a research agenda to advance this field.
Literatur
5.
Zurück zum Zitat Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. doi:10.1007/s00134-017-4683-6 Rhodes A, Evans LE, Alhazzani W et al (2017) Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. doi:10.​1007/​s00134-017-4683-6
8.
Zurück zum Zitat Phua J, Koh Y, Du B et al (2011) Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. BMJ 342:d3245PubMedPubMedCentralCrossRef Phua J, Koh Y, Du B et al (2011) Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. BMJ 342:d3245PubMedPubMedCentralCrossRef
9.
Zurück zum Zitat Noritomi DT, Ranzani OT, Monteiro MB et al (2014) Implementation of a multifaceted sepsis education program in an emerging country setting: clinical outcomes and cost-effectiveness in a long-term follow-up study. Intensive Care Med 40:182–191. doi:10.1007/s00134-013-3131-5 PubMedCrossRef Noritomi DT, Ranzani OT, Monteiro MB et al (2014) Implementation of a multifaceted sepsis education program in an emerging country setting: clinical outcomes and cost-effectiveness in a long-term follow-up study. Intensive Care Med 40:182–191. doi:10.​1007/​s00134-013-3131-5 PubMedCrossRef
10.
Zurück zum Zitat Rhodes A, Phillips G, Beale R et al (2015) The Surviving Sepsis Campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study). Intensive Care Med 41:1620–1628. doi:10.1007/s00134-015-3906-y PubMedCrossRef Rhodes A, Phillips G, Beale R et al (2015) The Surviving Sepsis Campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study). Intensive Care Med 41:1620–1628. doi:10.​1007/​s00134-015-3906-y PubMedCrossRef
11.
Zurück zum Zitat Shin TG, Jo IJ, Choi DJ et al (2013) The adverse effect of emergency department crowding on compliance with the resuscitation bundle in the management of severe sepsis and septic shock. Crit Care Lond Engl 17:R224. doi:10.1186/cc13047 CrossRef Shin TG, Jo IJ, Choi DJ et al (2013) The adverse effect of emergency department crowding on compliance with the resuscitation bundle in the management of severe sepsis and septic shock. Crit Care Lond Engl 17:R224. doi:10.​1186/​cc13047 CrossRef
12.
Zurück zum Zitat Almeida M, Ribeiro O, Aragão I et al (2013) Differences in compliance with Surviving Sepsis Campaign recommendations according to hospital entrance time: day versus night. Crit Care Lond Engl 17:R79. doi:10.1186/cc12689 CrossRef Almeida M, Ribeiro O, Aragão I et al (2013) Differences in compliance with Surviving Sepsis Campaign recommendations according to hospital entrance time: day versus night. Crit Care Lond Engl 17:R79. doi:10.​1186/​cc12689 CrossRef
17.
Zurück zum Zitat Zarychanski R, Abou-Setta AM, Turgeon AF et al (2013) Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis. JAMA 309:678–688. doi:10.1001/jama.2013.430 PubMedCrossRef Zarychanski R, Abou-Setta AM, Turgeon AF et al (2013) Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis. JAMA 309:678–688. doi:10.​1001/​jama.​2013.​430 PubMedCrossRef
20.
23.
Zurück zum Zitat ProCESS ARISE, Committee ProMISe Methodology Writing, Huang DT, Angus DC et al (2013) Harmonizing international trials of early goal-directed resuscitation for severe sepsis and septic shock: methodology of ProCESS, ARISE, and ProMISe. Intensive Care Med 39:1760–1775. doi:10.1007/s00134-013-3024-7 CrossRef ProCESS ARISE, Committee ProMISe Methodology Writing, Huang DT, Angus DC et al (2013) Harmonizing international trials of early goal-directed resuscitation for severe sepsis and septic shock: methodology of ProCESS, ARISE, and ProMISe. Intensive Care Med 39:1760–1775. doi:10.​1007/​s00134-013-3024-7 CrossRef
24.
26.
Zurück zum Zitat Hjortrup PB, Haase N, Bundgaard H et al (2016) Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial. Intensive Care Med 42:1695–1705. doi:10.1007/s00134-016-4500-7 PubMedCrossRef Hjortrup PB, Haase N, Bundgaard H et al (2016) Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial. Intensive Care Med 42:1695–1705. doi:10.​1007/​s00134-016-4500-7 PubMedCrossRef
27.
Zurück zum Zitat Girardis M, Busani S, Damiani E et al (2016) Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 316:1583–1589. doi:10.1001/jama.2016.11993 PubMedCrossRef Girardis M, Busani S, Damiani E et al (2016) Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit: the oxygen-ICU randomized clinical trial. JAMA 316:1583–1589. doi:10.​1001/​jama.​2016.​11993 PubMedCrossRef
28.
Zurück zum Zitat Angus DC, Linde-Zwirble WT, Lidicker J et al (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310PubMedCrossRef Angus DC, Linde-Zwirble WT, Lidicker J et al (2001) Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 29:1303–1310PubMedCrossRef
29.
Zurück zum Zitat Perner A, Haase N, Winkel P et al (2014) Long-term outcomes in patients with severe sepsis randomised to resuscitation with hydroxyethyl starch 130/0.42 or Ringer’s acetate. Intensive Care Med 40:927–934. doi:10.1007/s00134-014-3311-y PubMedCrossRef Perner A, Haase N, Winkel P et al (2014) Long-term outcomes in patients with severe sepsis randomised to resuscitation with hydroxyethyl starch 130/0.42 or Ringer’s acetate. Intensive Care Med 40:927–934. doi:10.​1007/​s00134-014-3311-y PubMedCrossRef
33.
Zurück zum Zitat Lamontagne F, Cohen D, Herridge M (2016) Understanding patient-centredness: contrasting expert versus patient perspectives on vasopressor therapy for shock. Intensive Care Med. doi:10.1007/s00134-016-4518-x Lamontagne F, Cohen D, Herridge M (2016) Understanding patient-centredness: contrasting expert versus patient perspectives on vasopressor therapy for shock. Intensive Care Med. doi:10.​1007/​s00134-016-4518-x
35.
Zurück zum Zitat Bafeta A, Dechartres A, Trinquart L et al (2012) Impact of single centre status on estimates of intervention effects in trials with continuous outcomes: meta-epidemiological study. BMJ 344:e813PubMedPubMedCentralCrossRef Bafeta A, Dechartres A, Trinquart L et al (2012) Impact of single centre status on estimates of intervention effects in trials with continuous outcomes: meta-epidemiological study. BMJ 344:e813PubMedPubMedCentralCrossRef
38.
Zurück zum Zitat Angus DC, Barnato AE, Bell D et al (2015) A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators. Intensive Care Med 41:1549–1560. doi:10.1007/s00134-015-3822-1 PubMedCrossRef Angus DC, Barnato AE, Bell D et al (2015) A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators. Intensive Care Med 41:1549–1560. doi:10.​1007/​s00134-015-3822-1 PubMedCrossRef
42.
Zurück zum Zitat Haase N, Wetterslev J, Winkel P, Perner A (2013) Bleeding and risk of death with hydroxyethyl starch in severe sepsis: post hoc analyses of a randomized clinical trial. Intensive Care Med 39:2126–2134. doi:10.1007/s00134-013-3111-9 PubMedCrossRef Haase N, Wetterslev J, Winkel P, Perner A (2013) Bleeding and risk of death with hydroxyethyl starch in severe sepsis: post hoc analyses of a randomized clinical trial. Intensive Care Med 39:2126–2134. doi:10.​1007/​s00134-013-3111-9 PubMedCrossRef
44.
Zurück zum Zitat Hébert PC, Wells G, Blajchman MA et al (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med 340:409–417. doi:10.1056/NEJM199902113400601 PubMedCrossRef Hébert PC, Wells G, Blajchman MA et al (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care. Transfusion Requirements in Critical Care Investigators, Canadian Critical Care Trials Group. N Engl J Med 340:409–417. doi:10.​1056/​NEJM199902113400​601 PubMedCrossRef
46.
Zurück zum Zitat Rygård SL, Holst LB, Wetterslev J et al (2016) Long-term outcomes in patients with septic shock transfused at a lower versus a higher haemoglobin threshold: the TRISS randomised, multicentre clinical trial. Intensive Care Med 42:1685–1694. doi:10.1007/s00134-016-4437-x PubMedCrossRef Rygård SL, Holst LB, Wetterslev J et al (2016) Long-term outcomes in patients with septic shock transfused at a lower versus a higher haemoglobin threshold: the TRISS randomised, multicentre clinical trial. Intensive Care Med 42:1685–1694. doi:10.​1007/​s00134-016-4437-x PubMedCrossRef
49.
Zurück zum Zitat Ziff OJ, Lane DA, Samra M et al (2015) Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data. BMJ 351:h4451PubMedPubMedCentralCrossRef Ziff OJ, Lane DA, Samra M et al (2015) Safety and efficacy of digoxin: systematic review and meta-analysis of observational and controlled trial data. BMJ 351:h4451PubMedPubMedCentralCrossRef
52.
54.
Zurück zum Zitat de Groot B, Ansems A, Gerling DH et al (2015) The association between time to antibiotics and relevant clinical outcomes in emergency department patients with various stages of sepsis: a prospective multi-center study. Crit Care Lond Engl 19:194. doi:10.1186/s13054-015-0936-3 CrossRef de Groot B, Ansems A, Gerling DH et al (2015) The association between time to antibiotics and relevant clinical outcomes in emergency department patients with various stages of sepsis: a prospective multi-center study. Crit Care Lond Engl 19:194. doi:10.​1186/​s13054-015-0936-3 CrossRef
55.
Zurück zum Zitat McGregor JC, Rich SE, Harris AD et al (2007) A systematic review of the methods used to assess the association between appropriate antibiotic therapy and mortality in bacteremic patients. Clin Infect Dis 45:329–337. doi:10.1086/519283 PubMedCrossRef McGregor JC, Rich SE, Harris AD et al (2007) A systematic review of the methods used to assess the association between appropriate antibiotic therapy and mortality in bacteremic patients. Clin Infect Dis 45:329–337. doi:10.​1086/​519283 PubMedCrossRef
57.
Zurück zum Zitat Abdul-Aziz MH, Sulaiman H, Mat-Nor M-B et al (2016) Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis. Intensive Care Med 42:1535–1545. doi:10.1007/s00134-015-4188-0 PubMedCrossRef Abdul-Aziz MH, Sulaiman H, Mat-Nor M-B et al (2016) Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis. Intensive Care Med 42:1535–1545. doi:10.​1007/​s00134-015-4188-0 PubMedCrossRef
59.
Zurück zum Zitat Shankar-Hari M, Harrison DA, Rowan KM (2016) Differences in impact of definitional elements on mortality precludes international comparisons of sepsis epidemiology-A cohort study illustrating the need for standardized reporting. Crit Care Med 44:2223–2230. doi:10.1097/CCM.0000000000001876 PubMedCrossRef Shankar-Hari M, Harrison DA, Rowan KM (2016) Differences in impact of definitional elements on mortality precludes international comparisons of sepsis epidemiology-A cohort study illustrating the need for standardized reporting. Crit Care Med 44:2223–2230. doi:10.​1097/​CCM.​0000000000001876​ PubMedCrossRef
60.
64.
Zurück zum Zitat Rygård SL, Holst LB, Wetterslev J et al (2017) Higher vs. lower haemoglobin threshold for transfusion in septic shock: subgroup analyses of the TRISS trial. Acta Anaesthesiol Scand 61:166–175. doi:10.1111/aas.12837 PubMedCrossRef Rygård SL, Holst LB, Wetterslev J et al (2017) Higher vs. lower haemoglobin threshold for transfusion in septic shock: subgroup analyses of the TRISS trial. Acta Anaesthesiol Scand 61:166–175. doi:10.​1111/​aas.​12837 PubMedCrossRef
70.
74.
Zurück zum Zitat Heyland DK, Muscedere J, Drover J et al (2011) Persistent organ dysfunction plus death: a novel, composite outcome measure for critical care trials. Crit Care Lond Engl 15:R98. doi:10.1186/cc10110 CrossRef Heyland DK, Muscedere J, Drover J et al (2011) Persistent organ dysfunction plus death: a novel, composite outcome measure for critical care trials. Crit Care Lond Engl 15:R98. doi:10.​1186/​cc10110 CrossRef
77.
Zurück zum Zitat Wiedemann HP, Wheeler AP, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575. doi:10.1056/NEJMoa062200 PubMedCrossRef Wiedemann HP, Wheeler AP, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network et al (2006) Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 354:2564–2575. doi:10.​1056/​NEJMoa062200 PubMedCrossRef
78.
Zurück zum Zitat Hranjec T, Rosenberger LH, Swenson B et al (2012) Aggressive versus conservative initiation of antimicrobial treatment in critically ill surgical patients with suspected intensive-care-unit-acquired infection: a quasi-experimental, before and after observational cohort study. Lancet Infect Dis 12:774–780. doi:10.1016/S1473-3099(12)70151-2 PubMedPubMedCentralCrossRef Hranjec T, Rosenberger LH, Swenson B et al (2012) Aggressive versus conservative initiation of antimicrobial treatment in critically ill surgical patients with suspected intensive-care-unit-acquired infection: a quasi-experimental, before and after observational cohort study. Lancet Infect Dis 12:774–780. doi:10.​1016/​S1473-3099(12)70151-2 PubMedPubMedCentralCrossRef
79.
Zurück zum Zitat Lamontagne F, Meade MO, Hébert PC et al (2016) Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med 42:542–550. doi:10.1007/s00134-016-4237-3 PubMedCrossRef Lamontagne F, Meade MO, Hébert PC et al (2016) Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. Intensive Care Med 42:542–550. doi:10.​1007/​s00134-016-4237-3 PubMedCrossRef
81.
Zurück zum Zitat Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316:509–518. doi:10.1001/jama.2016.10485 PubMedCrossRef Gordon AC, Mason AJ, Thirunavukkarasu N et al (2016) Effect of early vasopressin vs norepinephrine on kidney failure in patients with septic shock: the VANISH randomized clinical trial. JAMA 316:509–518. doi:10.​1001/​jama.​2016.​10485 PubMedCrossRef
82.
83.
84.
Zurück zum Zitat Dishy V, Sofowora GG, Xie HG et al (2001) The effect of common polymorphisms of the beta2-adrenergic receptor on agonist-mediated vascular desensitization. N Engl J Med 345:1030–1035. doi:10.1056/NEJMoa010819 PubMedCrossRef Dishy V, Sofowora GG, Xie HG et al (2001) The effect of common polymorphisms of the beta2-adrenergic receptor on agonist-mediated vascular desensitization. N Engl J Med 345:1030–1035. doi:10.​1056/​NEJMoa010819 PubMedCrossRef
87.
Zurück zum Zitat Venkatesh B, Myburgh J, Finfer S et al (2013) The ADRENAL study protocol: adjunctive corticosteroid treatment in critically ill patients with septic shock. Crit Care Resusc 15:83–88PubMed Venkatesh B, Myburgh J, Finfer S et al (2013) The ADRENAL study protocol: adjunctive corticosteroid treatment in critically ill patients with septic shock. Crit Care Resusc 15:83–88PubMed
91.
Zurück zum Zitat Lowes DA, Webster NR, Murphy MP, Galley HF (2013) Antioxidants that protect mitochondria reduce interleukin-6 and oxidative stress, improve mitochondrial function, and reduce biochemical markers of organ dysfunction in a rat model of acute sepsis. Br J Anaesth 110:472–480. doi:10.1093/bja/aes577 PubMedPubMedCentralCrossRef Lowes DA, Webster NR, Murphy MP, Galley HF (2013) Antioxidants that protect mitochondria reduce interleukin-6 and oxidative stress, improve mitochondrial function, and reduce biochemical markers of organ dysfunction in a rat model of acute sepsis. Br J Anaesth 110:472–480. doi:10.​1093/​bja/​aes577 PubMedPubMedCentralCrossRef
92.
Zurück zum Zitat Lancel S, Hassoun SM, Favory R et al (2009) Carbon monoxide rescues mice from lethal sepsis by supporting mitochondrial energetic metabolism and activating mitochondrial biogenesis. J Pharmacol Exp Ther 329:641–648. doi:10.1124/jpet.108.148049 PubMedCrossRef Lancel S, Hassoun SM, Favory R et al (2009) Carbon monoxide rescues mice from lethal sepsis by supporting mitochondrial energetic metabolism and activating mitochondrial biogenesis. J Pharmacol Exp Ther 329:641–648. doi:10.​1124/​jpet.​108.​148049 PubMedCrossRef
94.
95.
Zurück zum Zitat Reinhart K, Menges T, Gardlund B et al (2001) Randomized, placebo-controlled trial of the anti-tumor necrosis factor antibody fragment afelimomab in hyperinflammatory response during severe sepsis: the RAMSES Study. Crit Care Med 29:765–769PubMedCrossRef Reinhart K, Menges T, Gardlund B et al (2001) Randomized, placebo-controlled trial of the anti-tumor necrosis factor antibody fragment afelimomab in hyperinflammatory response during severe sepsis: the RAMSES Study. Crit Care Med 29:765–769PubMedCrossRef
100.
Zurück zum Zitat James ND, Sydes MR, Clarke NW et al (2016) Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet 387:1163–1177. doi:10.1016/S0140-6736(15)01037-5 PubMedPubMedCentralCrossRef James ND, Sydes MR, Clarke NW et al (2016) Addition of docetaxel, zoledronic acid, or both to first-line long-term hormone therapy in prostate cancer (STAMPEDE): survival results from an adaptive, multiarm, multistage, platform randomised controlled trial. Lancet 387:1163–1177. doi:10.​1016/​S0140-6736(15)01037-5 PubMedPubMedCentralCrossRef
Metadaten
Titel
The intensive care medicine research agenda on septic shock
verfasst von
Anders Perner
Anthony C. Gordon
Derek C. Angus
Francois Lamontagne
Flavia Machado
James A. Russell
Jean-Francois Timsit
John C. Marshall
John Myburgh
Manu Shankar-Hari
Mervyn Singer
Publikationsdatum
12.05.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Intensive Care Medicine / Ausgabe 9/2017
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-017-4821-1

Weitere Artikel der Ausgabe 9/2017

Intensive Care Medicine 9/2017 Zur Ausgabe

Imaging in Intensive Care Medicine

Trichosporon inkin disseminated infection

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.