The Sepsis III definitions provide a theoretical framework for understanding sepsis/septic shock. While clinical criteria were developed to move this framework into practice, the criteria were not derived as clinical decision tools (10.1164/rccm.201605-1005ED). As such, it is not clear how to incorporate the Sepsis III clinical criteria into existing practice guidelines.
When should qSOFA/SOFA be measured? Should serial measurements be performed? Is there still a role for SIRS? What clinical decisions (if any) should be made when a patient is qSOFA positive? qSOFA negative?
The Surviving Sepsis Campaign (survivingsepsis.org/SiteCollec...) provided some guidance on how to incorporate Sepsis III into their existing sepsis identification/treatment framework. Other academic societies and regulatory bodies have been slower to adopt the definitions into practice.
As has been noted previously, consensus across the research/clinical/regulatory domains in how sepsis is 'diagnosed' is crucial. What further steps are needed to ensure wide adoption of the updated definitions into clinical practice guidelines?
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