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Current practice and evolving concepts in septic shock resuscitation

Research output: Contribution to journalArticlepeer-review

Jan Bakker, Eduardo Kattan, Djillali Annane, Ricardo Castro, Maurizio Cecconi, Daniel de Backer, Arnaldo Dubin, Laura Evans, Michelle Ng Gong, Olfa Hamzaoui, Can Ince, Bruno Levy, Xavier Monnet, Gustavo A.Ospina Tascón, Marlies Ostermann, Michal R. Pinsky, James A. Russell, Bernd Saugel, Thomas W.L. Scheeren, Jean Louis Teboul & 4 more Antoine Vieillard Baron, Jean Louis Vincent, Fernando G. Zampieri, Glenn Hernandez

Original languageEnglish
JournalIntensive Care Medicine
Early online date15 Dec 2021
DOIs
Accepted/In press2021
E-pub ahead of print15 Dec 2021

Bibliographical note

Funding Information: DA, JB, RC, DDB, AD, LE, MNG, OH, GH, EK, BL, XM, GOT, MO, MP, JR, TWLS, JLT, AVB, JLV, FGZ declare no conflicts of interest. BS is a consultant for and has received honoraria for giving lectures from Edwards Lifesciences Inc. (Irvine, CA, USA). BS is a consultant for and has received institutional restricted research grants and honoraria for giving lectures from Pulsion Medical Systems SE (Feldkirchen, Germany). BS has received institutional restricted research grants and honoraria for giving lectures from CNSystems Medizintechnik GmbH (Graz, Austria). BS is a consultant for and has received honoraria for giving lectures from Philips Medizin Systeme Böblingen GmbH (Böblingen, Germany). BS is a consultant for and has received honoraria for giving lectures from GE Healthcare (Chicago, IL, USA). BS is a consultant for Vygon (Aachen, Germany). BS is a consultant for and has received institutional restricted research grants from Retia Medical LLC. (Valhalla, NY, USA). BS was a consultant for and has received institutional restricted research grants from Tensys Medical Inc. (San Diego, CA, USA); FGZ has received grants for investigator-initiated trials from Bactiguard, Sweden, and Ionis Pharmaceuticals, USA, unrelated to the scope of this work. FGZ was the principal investigator of the BaSICS trial, which received logistics support from Baxter Hospitalar, Brazil; CI received educational grants from LaJolla Pharmaceuticals (LaJolla, Cal USA) and educational grants and speaker fees from Cytosorbents Europe (Berlin Germany). CI is Chief Scientific Officer and holds shares in Active Medical BV (Leiden, The Netherlands), a company that provides educational services, products and software related to clinical microcirculation using sublingual hand-held vital microscopes; AVB received a research grant from GSK. AVB received Fees from Air Liquide for being in an advisory board for conducting a clinical research; BL received grants from Novartis, Abiomed, Amomed, orion, Gettinge; MC performed consultancies for Edwards Lifesciences and Directed Systems; Publisher Copyright: © 2021, Springer-Verlag GmbH Germany, part of Springer Nature.

King's Authors

Abstract

Clinical and pathophysiological understanding of septic shock has progressed exponentially in the previous decades, translating into a steady decrease in septic shock-related morbidity and mortality. Even though large randomized, controlled trials have addressed fundamental aspects of septic shock resuscitation, many questions still exist. In this review, we will describe the current standards of septic shock resuscitation, but the emphasis will be placed on evolving concepts in different domains such as clinical resuscitation targets, adequate use of fluids and vasoactive drugs, refractory shock, and the use of extracorporeal therapies. Multiple research opportunities remain open, and collaborative endeavors should be performed to fill in these gaps.

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