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Practice Guideline
. 2010 Jun 28:8:Doc14.
doi: 10.3205/000103.

Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI))

[Article in English, German]
K Reinhart  1 , F M Brunkhorst, H-G Bone, J Bardutzky, C-E Dempfle, H Forst, P Gastmeier, H Gerlach, M Gründling, S John, W Kern, G Kreymann, W Krüger, P Kujath, G Marggraf, J Martin, K Mayer, A Meier-Hellmann, M Oppert, C Putensen, M Quintel, M Ragaller, R Rossaint, H Seifert, C Spies, F Stüber, N Weiler, A Weimann, K Werdan, T Welte; German Sepsis Society; German Interdisciplinary Association of Intensive Care and Emergency Medicine
Affiliations
Practice Guideline

Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2k guidelines of the German Sepsis Society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary Association of Intensive Care and Emergency Medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI))

[Article in English, German]
K Reinhart et al. Ger Med Sci. .

Abstract
in English, German

Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1(st) revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge) on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care) of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the "German Instrument for Methodological Guideline Appraisal" of the Association of the Scientific Medical Societies (AWMF). In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be periodically initiated. The guideline recommendations may not be applied under all circumstances. It rests with the clinician to decide whether a certain recommendation should be adopted or not, taking into consideration the unique set of clinical facts presented in connection with each individual patient as well as the available resources.

Leitlinien sind systematisch entwickelte Darstellungen und Empfehlungen mit dem Zweck, Ärzte und Patienten bei der Entscheidung über angemessene Maßnahmen der Krankenversorgung unter spezifischen medizinischen Umständen und unter Berücksichtigung des spezifischen nationalen Gesundheitssystems zu unterstützen. Die erste Revision der S-2k-Leitlinie der Deutschen Sepsis-Gesellschaft in Kooperation mit 17 weiteren wissenschaftlichen medizinischen Fachgesellschaften und einer Selbsthilfegruppe gibt den Stand des Wissens (Ergebnisse von kontrollierten klinischen Studien und Wissen von Experten) über effektive und angemessene Krankenversorgung zum Zeitpunkt der „Drucklegung“ wieder. Die Leitlinienentwicklung erfolgte entsprechend des „Deutschen Instrumentes zur methodischen Leitlinien-Bewertung“ der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF). In Anbetracht der unausbleiblichen Fortschritte wissenschaftlicher Erkenntnisse und der Technik müssen periodische Überarbeitungen, Erneuerungen und Korrekturen unternommen werden. Die Empfehlungen der Leitlinien können nicht unter allen Umständen angemessen genutzt werden. Die Entscheidung darüber, ob einer bestimmten Empfehlung gefolgt werden soll, muß vom Arzt unter Berücksichtigung der beim individuellen Patienten vorliegenden Gegebenheiten und der verfügbaren Ressourcen getroffen werden.

Keywords: German Sepsis Aid; German Sepsis Society; diagnosis; follow-up care; guideline; prevention; septic shock; severe sepsis; treatment.

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Figures

Table 1
Table 1. Diagnostic criteria for sepsis, severe sepsis and septic shock (modified after [411]), in line with the ACCP/SCCM consensus conference criteria [11].
Table 2
Table 2. Collection, storage and transport of blood cultures [33]
Table 3
Table 3. Modified “clinical pulmonary infection score (CPIS)” [43]
Table 4
Table 4. SDD and SOD regimens according to Krüger WA, IntensivNews 2009, mod. after: de Smet et al, New Engl J Med. 2009;360:20-31 [137]. In a modified form, following mouth cleansing and oral suction, SDD or SOD may also be administered with a syringe as oral suspensions: 10 ml q.i.d. according to the following formulation: 1.0 g polymyxin E = Colistin (alternatively, 0.5 g polymyxin B), 800 mg of tobramycin, 2.5 g of amphotericin B ad 100 mL distilled water)
Table 5
Table 5. Definition of criteria for acute kidney injury (AKI) [412]
Table 6
Table 6. Definition of acute lung injury (ALI) and adult respiratory distress syndrome (ARDS)
Table 7
Table 7. Ventilation management in ALI/ARDS patients according to the recommendations by ARDSNET [290], modified as per [22].
Figure 1
Figure 1. An example of a weaning scheme after Kuhlen (modified after [303, 413])
See this image and copyright information in PMC

References

    1. Yusuf S, Teo K, Woods K. Intravenous magnesium in acute myocardial infarction: An effective, safe, simple, and inexpensive intervention. Circulation. 1993;87(6):2043–2046. - PubMed
    1. ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group. ISIS-4:a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet. 1995;345(8951):669–685. doi: 10.1016/S0140-6736(95)90865-X. Available from: http://dx.doi.org/10.1016/S0140-6736(95)90865-X. - DOI - DOI - PubMed
    1. Sackett DL. Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest. 1989;95(2 Suppl):2S–4S. - PubMed
    1. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546–1554. doi: 10.1056/NEJMoa022139. Available from: http://dx.doi.org/10.1056/NEJMoa022139. - DOI - DOI - PubMed
    1. Bates DW, Cook EF, Goldman L, Lee TH. Predicting bacteremia in hospitalized patients: A prospectively validated model. Ann Intern Med. 1990;113(7):495–500. - PubMed

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