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The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

Identifieur interne : 002261 ( PubMed/Curation ); précédent : 002260; suivant : 002262

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

Auteurs : Mervyn Singer [Royaume-Uni] ; Clifford S. Deutschman [États-Unis] ; Christopher Warren Seymour [États-Unis] ; Manu Shankar-Hari [Royaume-Uni] ; Djillali Annane [France] ; Michael Bauer [Allemagne] ; Rinaldo Bellomo [Australie] ; Gordon R. Bernard [États-Unis] ; Jean-Daniel Chiche [France] ; Craig M. Coopersmith [Géorgie (pays)] ; Richard S. Hotchkiss [États-Unis] ; Mitchell M. Levy [États-Unis] ; John C. Marshall [Canada] ; Greg S. Martin [Géorgie (pays)] ; Steven M. Opal [États-Unis] ; Gordon D. Rubenfeld [Canada] ; Tom Van Der Poll [Pays-Bas] ; Jean-Louis Vincent [Belgique] ; Derek C. Angus

Source :

JAMA [ 1538-3598 ] ; 2016.

RBID : pubmed:26903338

Descripteurs français

KwdFr :
- Choc septique (), Choc septique (diagnostic), Choc septique (mortalité), Choc septique (sang), Choc septique (traitement médicamenteux), Classification internationale des maladies, Comités consultatifs (organisation et administration), Fréquence respiratoire, Humains, Lactates (sang), Marqueurs biologiques (sang), Mortalité hospitalière, Méthode Delphi, Pression sanguine (), Scores de dysfonction d'organes, Sensibilité et spécificité, Sepsie (), Sepsie (diagnostic), Sepsie (mortalité), Sepsie (sang), Syndrome de réponse inflammatoire généralisée (diagnostic), Terminologie comme sujet, Vasoconstricteurs (usage thérapeutique), Évaluation de la recherche par les pairs.
MESH :
- diagnostic : Choc septique, Sepsie, Syndrome de réponse inflammatoire généralisée.
- mortalité : Choc septique, Sepsie.
- organisation et administration : Comités consultatifs.
- sang : Choc septique, Lactates, Marqueurs biologiques, Sepsie.
- traitement médicamenteux : Choc septique.
- usage thérapeutique : Vasoconstricteurs.
- Choc septique, Classification internationale des maladies, Fréquence respiratoire, Humains, Mortalité hospitalière, Méthode Delphi, Pression sanguine, Scores de dysfonction d'organes, Sensibilité et spécificité, Sepsie, Terminologie comme sujet, Évaluation de la recherche par les pairs.

English descriptors

KwdEn :
- Advisory Committees (organization & administration), Biomarkers (blood), Blood Pressure (drug effects), Delphi Technique, Hospital Mortality, Humans, International Classification of Diseases, Lactates (blood), Organ Dysfunction Scores, Peer Review, Research, Respiratory Rate, Sensitivity and Specificity, Sepsis (blood), Sepsis (classification), Sepsis (complications), Sepsis (diagnosis), Sepsis (mortality), Shock, Septic (blood), Shock, Septic (classification), Shock, Septic (diagnosis), Shock, Septic (drug therapy), Shock, Septic (mortality), Systemic Inflammatory Response Syndrome (diagnosis), Terminology as Topic, Vasoconstrictor Agents (therapeutic use).
MESH :
- chemical , blood : Biomarkers, Lactates.
- blood : Sepsis, Shock, Septic.
- classification : Sepsis, Shock, Septic.
- complications : Sepsis.
- diagnosis : Sepsis, Shock, Septic, Systemic Inflammatory Response Syndrome.
- drug effects : Blood Pressure.
- drug therapy : Shock, Septic.
- mortality : Sepsis, Shock, Septic.
- organization & administration : Advisory Committees.
- chemical , therapeutic use : Vasoconstrictor Agents.
- Delphi Technique, Hospital Mortality, Humans, International Classification of Diseases, Organ Dysfunction Scores, Peer Review, Research, Respiratory Rate, Sensitivity and Specificity, Terminology as Topic.

Abstract

Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.

DOI: 10.1001/jama.2016.0287
PubMed: 26903338

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Derek C. Angus

<affiliation><nlm:affiliation>Department of Critical Care Medicine, University of Pittsburgh and UPMC Health System, Pittsburgh, Pennsylvania20Associate Editor, JAMA.</nlm:affiliation>
<wicri:noCountry code="subField">JAMA</wicri:noCountry>
</affiliation>

Le document en format XML

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<author><name sortKey="Bellomo, Rinaldo" sort="Bellomo, Rinaldo" uniqKey="Bellomo R" first="Rinaldo" last="Bellomo">Rinaldo Bellomo</name>
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<author><name sortKey="Chiche, Jean Daniel" sort="Chiche, Jean Daniel" uniqKey="Chiche J" first="Jean-Daniel" last="Chiche">Jean-Daniel Chiche</name>
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<country xml:lang="fr">France</country>
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</affiliation>
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<author><name sortKey="Marshall, John C" sort="Marshall, John C" uniqKey="Marshall J" first="John C" last="Marshall">John C. Marshall</name>
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<country xml:lang="fr">Canada</country>
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<author><name sortKey="Van Der Poll, Tom" sort="Van Der Poll, Tom" uniqKey="Van Der Poll T" first="Tom" last="Van Der Poll">Tom Van Der Poll</name>
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<country xml:lang="fr" wicri:curation="lc">Pays-Bas</country>
<wicri:regionArea>Department of Infectious Diseases, Academisch Medisch Centrum, Amsterdam</wicri:regionArea>
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<author><name sortKey="Vincent, Jean Louis" sort="Vincent, Jean Louis" uniqKey="Vincent J" first="Jean-Louis" last="Vincent">Jean-Louis Vincent</name>
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<country xml:lang="fr">Belgique</country>
<wicri:regionArea>Department of Intensive Care, Erasme University Hospital, Brussels</wicri:regionArea>
</affiliation>
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<affiliation><nlm:affiliation>Department of Critical Care Medicine, University of Pittsburgh and UPMC Health System, Pittsburgh, Pennsylvania20Associate Editor, JAMA.</nlm:affiliation>
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<term>Lactates (blood)</term>
<term>Organ Dysfunction Scores</term>
<term>Peer Review, Research</term>
<term>Respiratory Rate</term>
<term>Sensitivity and Specificity</term>
<term>Sepsis (blood)</term>
<term>Sepsis (classification)</term>
<term>Sepsis (complications)</term>
<term>Sepsis (diagnosis)</term>
<term>Sepsis (mortality)</term>
<term>Shock, Septic (blood)</term>
<term>Shock, Septic (classification)</term>
<term>Shock, Septic (diagnosis)</term>
<term>Shock, Septic (drug therapy)</term>
<term>Shock, Septic (mortality)</term>
<term>Systemic Inflammatory Response Syndrome (diagnosis)</term>
<term>Terminology as Topic</term>
<term>Vasoconstrictor Agents (therapeutic use)</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Choc septique ()</term>
<term>Choc septique (diagnostic)</term>
<term>Choc septique (mortalité)</term>
<term>Choc septique (sang)</term>
<term>Choc septique (traitement médicamenteux)</term>
<term>Classification internationale des maladies</term>
<term>Comités consultatifs (organisation et administration)</term>
<term>Fréquence respiratoire</term>
<term>Humains</term>
<term>Lactates (sang)</term>
<term>Marqueurs biologiques (sang)</term>
<term>Mortalité hospitalière</term>
<term>Méthode Delphi</term>
<term>Pression sanguine ()</term>
<term>Scores de dysfonction d'organes</term>
<term>Sensibilité et spécificité</term>
<term>Sepsie ()</term>
<term>Sepsie (diagnostic)</term>
<term>Sepsie (mortalité)</term>
<term>Sepsie (sang)</term>
<term>Syndrome de réponse inflammatoire généralisée (diagnostic)</term>
<term>Terminologie comme sujet</term>
<term>Vasoconstricteurs (usage thérapeutique)</term>
<term>Évaluation de la recherche par les pairs</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Biomarkers</term>
<term>Lactates</term>
</keywords>
<keywords scheme="MESH" qualifier="blood" xml:lang="en"><term>Sepsis</term>
<term>Shock, Septic</term>
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<term>Systemic Inflammatory Response Syndrome</term>
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<term>Sepsie</term>
<term>Syndrome de réponse inflammatoire généralisée</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Blood Pressure</term>
</keywords>
<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Shock, Septic</term>
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<term>Shock, Septic</term>
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<term>Sepsie</term>
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</keywords>
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<term>Lactates</term>
<term>Marqueurs biologiques</term>
<term>Sepsie</term>
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<term>Hospital Mortality</term>
<term>Humans</term>
<term>International Classification of Diseases</term>
<term>Organ Dysfunction Scores</term>
<term>Peer Review, Research</term>
<term>Respiratory Rate</term>
<term>Sensitivity and Specificity</term>
<term>Terminology as Topic</term>
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<term>Classification internationale des maladies</term>
<term>Fréquence respiratoire</term>
<term>Humains</term>
<term>Mortalité hospitalière</term>
<term>Méthode Delphi</term>
<term>Pression sanguine</term>
<term>Scores de dysfonction d'organes</term>
<term>Sensibilité et spécificité</term>
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<front><div type="abstract" xml:lang="en">Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.</div>
</front>
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<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">26903338</PMID>
<DateCreated><Year>2016</Year>
<Month>02</Month>
<Day>23</Day>
</DateCreated>
<DateCompleted><Year>2016</Year>
<Month>03</Month>
<Day>01</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>10</Month>
<Day>18</Day>
</DateRevised>
<Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1538-3598</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>315</Volume>
<Issue>8</Issue>
<PubDate><Year>2016</Year>
<Month>Feb</Month>
<Day>23</Day>
</PubDate>
</JournalIssue>
<Title>JAMA</Title>
<ISOAbbreviation>JAMA</ISOAbbreviation>
</Journal>
<ArticleTitle>The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).</ArticleTitle>
<Pagination><MedlinePgn>801-10</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1001/jama.2016.0287</ELocationID>
<Abstract><AbstractText Label="IMPORTANCE" NlmCategory="OBJECTIVE">Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination.</AbstractText>
<AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To evaluate and, as needed, update definitions for sepsis and septic shock.</AbstractText>
<AbstractText Label="PROCESS" NlmCategory="METHODS">A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Definitions and clinical criteria were generated through meetings, Delphi processes, analysis of electronic health record databases, and voting, followed by circulation to international professional societies, requesting peer review and endorsement (by 31 societies listed in the Acknowledgment).</AbstractText>
<AbstractText Label="KEY FINDINGS FROM EVIDENCE SYNTHESIS" NlmCategory="UNASSIGNED">Limitations of previous definitions included an excessive focus on inflammation, the misleading model that sepsis follows a continuum through severe sepsis to shock, and inadequate specificity and sensitivity of the systemic inflammatory response syndrome (SIRS) criteria. Multiple definitions and terminologies are currently in use for sepsis, septic shock, and organ dysfunction, leading to discrepancies in reported incidence and observed mortality. The task force concluded the term severe sepsis was redundant.</AbstractText>
<AbstractText Label="RECOMMENDATIONS" NlmCategory="CONCLUSIONS">Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%. Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. In out-of-hospital, emergency department, or general hospital ward settings, adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes typical of sepsis if they have at least 2 of the following clinical criteria that together constitute a new bedside clinical score termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less.</AbstractText>
<AbstractText Label="CONCLUSIONS AND RELEVANCE" NlmCategory="CONCLUSIONS">These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Singer</LastName>
<ForeName>Mervyn</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Bloomsbury Institute of Intensive Care Medicine, University College London, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Deutschman</LastName>
<ForeName>Clifford S</ForeName>
<Initials>CS</Initials>
<AffiliationInfo><Affiliation>Hofstra-Northwell School of Medicine, Feinstein Institute for Medical Research, New Hyde Park, New York.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Seymour</LastName>
<ForeName>Christopher Warren</ForeName>
<Initials>CW</Initials>
<AffiliationInfo><Affiliation>Department of Critical Care and Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Shankar-Hari</LastName>
<ForeName>Manu</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Department of Critical Care Medicine, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Annane</LastName>
<ForeName>Djillali</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>Department of Critical Care Medicine, University of Versailles, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bauer</LastName>
<ForeName>Michael</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Center for Sepsis Control and Care, University Hospital, Jena, Germany.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bellomo</LastName>
<ForeName>Rinaldo</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, and Austin Hospital, Melbourne, Victoria, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Bernard</LastName>
<ForeName>Gordon R</ForeName>
<Initials>GR</Initials>
<AffiliationInfo><Affiliation>Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University, Nashville, Tennessee.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chiche</LastName>
<ForeName>Jean-Daniel</ForeName>
<Initials>JD</Initials>
<AffiliationInfo><Affiliation>Réanimation Médicale-Hôpital Cochin, Descartes University, Cochin Institute, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Coopersmith</LastName>
<ForeName>Craig M</ForeName>
<Initials>CM</Initials>
<AffiliationInfo><Affiliation>Critical Care Center, Emory University School of Medicine, Atlanta, Georgia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Hotchkiss</LastName>
<ForeName>Richard S</ForeName>
<Initials>RS</Initials>
<AffiliationInfo><Affiliation>Washington University School of Medicine, St Louis, Missouri.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Levy</LastName>
<ForeName>Mitchell M</ForeName>
<Initials>MM</Initials>
<AffiliationInfo><Affiliation>Infectious Disease Section, Division of Pulmonary and Critical Care Medicine, Brown University School of Medicine, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marshall</LastName>
<ForeName>John C</ForeName>
<Initials>JC</Initials>
<AffiliationInfo><Affiliation>Department of Surgery, University of Toronto, Toronto, Ontario, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Martin</LastName>
<ForeName>Greg S</ForeName>
<Initials>GS</Initials>
<AffiliationInfo><Affiliation>Emory University School of Medicine and Grady Memorial Hospital, Atlanta, Georgia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Opal</LastName>
<ForeName>Steven M</ForeName>
<Initials>SM</Initials>
<AffiliationInfo><Affiliation>Infectious Disease Section, Division of Pulmonary and Critical Care Medicine, Brown University School of Medicine, Providence, Rhode Island.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Rubenfeld</LastName>
<ForeName>Gordon D</ForeName>
<Initials>GD</Initials>
<AffiliationInfo><Affiliation>Trauma, Emergency & Critical Care Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada16Interdepartmental Division of Critical Care, University of Toronto.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>van der Poll</LastName>
<ForeName>Tom</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Department of Infectious Diseases, Academisch Medisch Centrum, Amsterdam, the Netherlands.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Vincent</LastName>
<ForeName>Jean-Louis</ForeName>
<Initials>JL</Initials>
<AffiliationInfo><Affiliation>Department of Intensive Care, Erasme University Hospital, Brussels, Belgium.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Angus</LastName>
<ForeName>Derek C</ForeName>
<Initials>DC</Initials>
<AffiliationInfo><Affiliation>Department of Critical Care Medicine, University of Pittsburgh and UPMC Health System, Pittsburgh, Pennsylvania20Associate Editor, JAMA.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><GrantID>K23 GM104022</GrantID>
<Acronym>GM</Acronym>
<Agency>NIGMS NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant><GrantID>R01 GM044118</GrantID>
<Acronym>GM</Acronym>
<Agency>NIGMS NIH HHS</Agency>
<Country>United States</Country>
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   |texte=   The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).
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	Serveur d'exploration sur les relations entre la France et l'Australie
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The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

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