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. 2025 Jul 16.
doi: 10.1097/CCM.0000000000006796. Online ahead of print.

The Sepsis Chain of Survival: A Comprehensive Framework for Improving Sepsis Outcomes

Jorge L Hidalgo  1 , Vishakha K Kumar  2 , Samuel O Akech  3 , Sheila N Myatra  4 , Shevin T Jacob  5 , Teresa Kortz  6   7 , Amanda A Vasquez  8 , Maria Cristina Jiménez Bazzano  9 , Marilia Diaz  10   11 , Jennifer Del Rio Rodríguez  10 , Ana Luisa Najera Garcia  12 , Rocio Giron  13 , Judith Jacobi  14 , Maureen A Madden  15 , Vinay Nadkarni  16
Affiliations

The Sepsis Chain of Survival: A Comprehensive Framework for Improving Sepsis Outcomes

Jorge L Hidalgo et al. Crit Care Med. .

Abstract

The "Chain of Survival" concept, developed for cardiac arrest, emphasizes a seamless and interconnected set, of time-critical interventions that are not strictly linear, to improve survival. This paradigm of urgent recognition and response to life-threatening conditions has evolved to apply to acute medical conditions, including sepsis. The "Sepsis Chain of Survival" underscores the importance of early recognition, prompt emergency medical services activation, timely antimicrobial administration and appropriate fluid resuscitation, optimized critical care management, effective source control and infection management, and comprehensive post-sepsis care. By adopting this approach, healthcare systems can improve sepsis outcomes through a coordinated, multifaceted strategy. This model highlights the critical role of public and healthcare worker awareness, education, community response, and continuous monitoring. Addressing the importance and interdependence of each link, this framework aims to improve survival rates and patient recovery by ensuring timely and effective sepsis management across diverse resource settings in infants, children, and adults.

Keywords: chain of survival; critical care management; early recognition; emergency response; post-sepsis care; sepsis.

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Conflict of interest statement

Dr. Hidalgo received support for article research from the Laerdal Foundation. Dr. Kumar’s institution received funding from the National Institutes of Health (NIH)/ the National Heart, Lung, and Blood Institute. Dr. Myatra is a member of the Surviving Sepsis Campaign guidelines committee. Drs. Kumar’s and Nadkarni’s institutions received funding from the Laerdal Foundation. Dr. Jacob’s institution received funding from the German Federal Ministry of Education and Research, the U.K. National Institute for Health and Care Research, and the U.K. Medical Research Council; they disclosed that they are a Board and Executive Member of the Global Sepsis Alliance and African Sepsis Alliance and a member of the Surviving Sepsis Campaign guidelines development committee. Dr. Kortz’s institution received funding from the National Institute of Allergy and Infectious Diseases (award number K23AI144029). Dr. Jacobi received funding from the Visante Pharmacy Consulting; she disclosed that she was on the Pfizer Hospital Products Division Advisory Board. Dr. Nadkarni’s institution received funding from the NIH, the U.S. Department of Defense, the Agency for Healthcare Quality and Safety, the Zoll Medical, and the American Heart Association; he received funding from the Society of Critical Care Medicine; and he received support for article research from the NIH. Dr. Madden received funding from Elsevier, the American College of Critical Care Medicine Board of Regents, the National Association of Pediatric Nurse Practitioners, and the AACN National Teaching Institute. The remaining authors have disclosed that they do not have any potential conflicts of interest.

References

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