Sepsis-3: A step forward in the definition and early diagnosis of Sepsis
Dear Srishti JAIN,
We are delighted to share that newly updated definitions and clinical criteria of sepsis, designated ‘Sepsis-3' have been published today in JAMA (online 22 February 2016).
‘Sepsis-3' aims to simplify and clarify terminology related to the syndrome, to improve consistency for epidemiology and research purposes, and to facilitate earlier recognition and more timely management of patients with, or at risk of developing sepsis. The definitions encompass an up-to-date understanding of sepsis biology, while accompanying clinical criteria provide practitioners in pre-hospital, emergency departments (EDs) and hospital ward settings with a simple bedside tool (qSOFA, quickSOFA) to better identify those patients with suspected infection likely to progress to a life-threatening state.
The first definitions of the sepsis syndrome developed in 1991 were based on the presence of presumed infection and at least two of four Systemic Inflammatory Response Syndrome (SIRS) criteria. A 2001 Task Force, recognising limitations with these initial definitions, included an expanded list of both clinical and laboratory abnormalities. However, in recent years, increased knowledge of the underlying pathophysiology and growing evidence of poor clinical and epidemiological utility of previous classifications such as "severe sepsis" and "septic shock" have highlighted the need for new definitions of these terms.
In order to meet this key clinical and research deficit, the European Society of Intensive Care Medicine (ESICM) and the Society of Critical Care Medicine (SCCM) convened the Sepsis Definitions Task Force, a group composed of 19 members with expertise in sepsis pathophysiology, clinical trials and epidemiology. Over the past two years, the Task Force have generated the definitions and clinical criteria for sepsis and septic shock through meetings, Delphi processes, analysis of electronic health record databases (including approximately 900,000 patients with suspected infection) and voting, followed by circulation to international professional societies requesting peer review and endorsement.
Prof Mervyn Singer, co-Chair of the Sepsis Definitions Task Force:
“The development of these definitions and clinical criteria mark a clear step forward for the diagnosis and treatment of sepsis for both researchers and clinicians, Derived from the current best knowledge and large-scale patient data (over 900,000 patients), we hope that simple clinical criteria such as qSOFA can help quickly identify patients with suspected infection who are likely to have poor outcomes, in pre-hospital and hospital settings alike."
The Task Force stresses that Sepsis-3 is the next step forward in an ongoing iterative process, and as new mechanistic knowledge, new diagnostic approaches, and enhanced collection of data become available, the definitions and criteria can be expected to change and adapt.
The three papers produced by the Sepsis Definitions Task Force:
- Singer M et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA, February 23, 2016, Vol 315, No. 8
- Shankar-Hari M et al. Developing a new definition and assessing new clinical criteria for septic shock: For the Third International Consensus Definitions for Sepsis and Septic 3 Shock (Sepsis-3). JAMA, February 23, 2016, Vol 315, No. 8
- Seymour, CW et al. Assessment of clinical criteria for sepsis. JAMA, February 23, 2016, Vol 315, No. 8
To watch an in-depth icTV interview with Mervyn Singer, author of the main paper, click here.
For more Sepsis resources, visit: www.esicm.org/sepsis/resources
Sincerely,
 
Daniel De Backer Maurizio Cecconi
ESICM President Chair of the ESICM Communications Committee
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