Updated Guidelines Address Hemodynamic Support of Sepsis

DES PLAINES, Ill. -- Newly revised practice parameters for hemodynamic support of sepsis in adult patients are published in the September issue of Critical Care Medicine and available on the Society of Critical Care Medicine's Web sit at www.sccm.org.

"These guidelines should improve patient outcomes," says Steven M. Hollenberg, MD, chairman of the American College of Critical Care Medicine Task Force to formulate guidelines for hemodynamic support of adult patients with septic shock and the lead author of the practice parameters. 

"Many physicians are already practicing within the parameters of the revised guidelines, but in some instances the practice parameters will improve therapy," he continues. Hollenberg is professor of medicine at Robert Wood Johnson Medical School/University of Medicine & Dentistry of New Jersey and director of the coronary care unit at Cooper University Hospital in Camden, N.J.

The practice parameters were developed to assist healthcare providers in the management of hemodynamic support for adult patients with sepsis and septic shock.  The practice parameters were developed by a panel convened by the American College of Critical Care Medicine of the Society of Critical Care Medicine.  The guidelines are based on medical literature relevant to hemodynamic support of septic patients and supplemented by the expertise and experience of members of an international task force convened from the membership of the Society of Critical Care Medicine.

"The structure of the parameters and the fundamental principles are not changed from the 1999 guidelines.  However, research findings during the last five years have lead to three new recommendations," says Hollenberg.

The guidelines are based on the fundamental principle that clinicians using hemodynamic therapies should define specific goals and endpoints, titrate therapies to those endpoints, and evaluate the results of their interventions on an ongoing basis by monitoring a combination of parameters of global and regional perfusion.  Using this approach, specific recommendations for fluid resuscitation, vasopressor therapy, and inotropic therapy of sepsis in adult patients were promulgated.

"As a profession, critical care is continually finding new ways to advance and improve outcomes and patient safety," said Joseph E. Parrillo, MD, editor-in-chief of Critical Care Medicine.  "The new guidelines published in this month's issue are a good example of critical care's pursuit of excellence." 

Shock, a syndrome that may arise from several causes, occurs when the circulatory system fails to adequately nourish the body's cells.  If shock is not reversed, irreversible cellular damage and then organ damage may ensue, possibly resulting in death.  Septic shock requires early, vigorous resuscitation. 

Source: Society of Critical Care Medicine