[Diagnosis and therapy of sepsis. Guidelines of the German Sepsis Society Inc. and the German Interdisciplinary Society for Intensive and Emergency Medicine].

K Reinhart, F Brunkhorst, H Bone, H Gerlach, M Gründling, G Kreymann, P Kujath, G Marggraf, K Mayer, A Meier-Hellmann, C Peckelsen, C Putensen, M Quintel, M Ragaller, R Rossaint, F Stüber, N Weiler, T Welte, K Werdan, Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI), Deutschen Sepsis-Gesellschaft e.V. (DSG)
Author Information
  1. K Reinhart: Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum der Friedrich-Schiller-Universität Jena.

Abstract

A recent survey conducted by the publicly funded Competence Network Sepsis (SepNet) reveals that severe sepsis and/or septic shock occurs in 75,000 inhabitants (110 out of 100,000) and sepsis in 79,000 inhabitants (116 out of 100,000) in Germany annually. This illness is responsible for approximately 60,000 deaths and ranges as the third most frequent cause of death after acute myocardial infarction. Direct costs for the intensive care of patients with severe sepsis alone amount to approximately 1.77 billion euros, which means that about 30% of the budget in intensive care is used to treat severe sepsis. However, until now German guidelines for the diagnosis and therapy of severe sepsis did not exist. Therefore, the German Sepsis Society initiated the development of guidelines which are based on international recommendations by the International Sepsis Forum (ISF) and the Surviving Sepsis Campaign (SSC) and take into account the structure and organization of the German health care system. Priority was given to the following guideline topics: a) diagnosis, b) prevention, c) causative therapy, d) supportive therapy, e) adjunctive therapy. The guidelines development process was carefully planned and strictly adhered to the requirements of the Working Group of Scientific Medical Societies (AWMF).

References

  1. JAMA. 2002 Aug 21;288(7):862-71 [PMID: 12186604]
  2. Crit Care Med. 2005 Apr;33(4):787-91 [PMID: 15818106]
  3. Cochrane Database Syst Rev. 2002;(1):CD001208 [PMID: 11869596]
  4. Drug Saf. 2003;26(3):197-207 [PMID: 12580648]
  5. Eur J Clin Microbiol Infect Dis. 1998 Jun;17 (6):377-84 [PMID: 9758274]
  6. Lancet. 2000 Dec 23-30;356(9248):2139-43 [PMID: 11191541]
  7. Ann Surg. 1980 Aug;192(2):169-74 [PMID: 7406571]
  8. J Infect Dis. 1996 Sep;174(3):529-36 [PMID: 8769610]
  9. J Antimicrob Chemother. 1992 Jul;30(1):73-87 [PMID: 1429339]
  10. Intensive Care Med. 2004 Mar;30(3):388-94 [PMID: 14714107]
  11. Lancet. 1992 Jul 4;340(8810):5-9 [PMID: 1351620]
  12. Anesthesiology. 1998 Jul;89(1):49-57 [PMID: 9667293]
  13. Chest. 1999 Feb;115(2):462-74 [PMID: 10027448]
  14. Antimicrob Agents Chemother. 2005 Jun;49(6):2260-6 [PMID: 15917519]
  15. Cochrane Database Syst Rev. 2004;(3):CD003709 [PMID: 15266497]
  16. Intensive Care Med. 2001;27 Suppl 1:S33-48 [PMID: 11307369]
  17. Arch Surg. 1998 Jan;133(1):94-100 [PMID: 9438767]
  18. Am J Med. 1980 Mar;68(3):344-55 [PMID: 6987871]
  19. Nutrition. 2002 Jul-Aug;18(7-8):546-52 [PMID: 12093428]
  20. Am J Respir Crit Care Med. 1998 Jan;157(1):76-80 [PMID: 9445281]
  21. Nutrition. 1997 Apr;13(4):295-302 [PMID: 9178278]
  22. Intensive Care Med. 2002 Aug;28(8):1058-63 [PMID: 12185425]
  23. Dtsch Med Wochenschr. 1995 Apr 7;120(14):498-502 [PMID: 7712946]
  24. Crit Care Med. 1991 Dec;19(12):1486-90 [PMID: 1959367]
  25. Clin Infect Dis. 1995 Mar;20(3):593-7 [PMID: 7756481]
  26. Clin Infect Dis. 2004 Jul 1;39(1):38-46 [PMID: 15206051]
  27. Intensive Care Med. 2005 Jan;31(1):12-23 [PMID: 15592814]
  28. Chest. 2003 Nov;124(5):1789-97 [PMID: 14605050]
  29. Am J Respir Crit Care Med. 2003 Feb 15;167(4):512-20 [PMID: 12426230]
  30. Am J Infect Control. 1985 Jun;13(3):97-108 [PMID: 3849273]
  31. Chest. 1990 Aug;98(2):405-10 [PMID: 2198140]
  32. Ann Intern Med. 1992 May 15;116(10):821-8 [PMID: 1567096]
  33. Intensive Care Med. 2005 May;31(5):645-8 [PMID: 15868138]
  34. Am J Respir Crit Care Med. 2000 Mar;161(3 Pt 1):775-9 [PMID: 10712321]
  35. J Clin Endocrinol Metab. 1981 Jul;53(1):58-68 [PMID: 7195404]
  36. Crit Care Med. 1990 Oct;18(10):1177-9 [PMID: 1976485]
  37. Crit Care Med. 1997 Aug;25(8):1417-24 [PMID: 9267959]
  38. Intensive Care Med. 1997 Mar;23(3):282-7 [PMID: 9083230]
  39. Am J Surg. 2005 Apr;189(4):425-8 [PMID: 15820454]
  40. Crit Care Med. 1999 Oct;27(10):2096-104 [PMID: 10548188]
  41. Scand J Infect Dis. 1997;29(1):71-5 [PMID: 9112302]
  42. Crit Care Med. 1990 Nov;18(11):1239-42 [PMID: 2225893]
  43. Arch Intern Med. 1996 Oct 14;156(18):2121-6 [PMID: 8862105]
  44. Anesth Analg. 2003 Oct;97(4):989-98 [PMID: 14500146]
  45. Chest. 2002 Nov;122(5):1727-36 [PMID: 12426278]
  46. Crit Care Med. 2004 Nov;32(11):2347 [PMID: 15640655]
  47. Intensive Care Med. 1992;18(7):398-404 [PMID: 1469177]
  48. Crit Care Med. 2002 Sep;30(9):2032-7 [PMID: 12352037]
  49. Eur J Anaesthesiol. 2001 Oct;18(10):662-7 [PMID: 11553242]
  50. Gut. 1999 Jul;45(1):82-8 [PMID: 10369709]
  51. Crit Care Med. 1997 Jun;25(6):989-94 [PMID: 9201052]
  52. Ann Intern Med. 1991 Oct 15;115(8):585-90 [PMID: 1892329]
  53. Antimicrob Agents Chemother. 2003 Jun;47(6):2015-7 [PMID: 12760889]
  54. JAMA. 1995 Aug 23-30;274(8):639-44 [PMID: 7637145]
  55. Circulation. 1993 Jun;87(6):2043-6 [PMID: 8504519]
  56. Crit Care Med. 1999 Nov;27(11):2346-50 [PMID: 10579246]
  57. Am J Surg. 2004 Dec;188(6):760-6 [PMID: 15619496]
  58. Lancet. 1999 Sep 25;354(9184):1071-7 [PMID: 10509498]
  59. Intensive Care Med. 1987;13(2):106-13 [PMID: 3033040]
  60. J Infect Dis. 1997 Dec;176(6):1538-51 [PMID: 9395366]
  61. Crit Care Med. 1998 Oct;26(10):1621-2 [PMID: 9781709]
  62. Intensive Care Med. 1998 Jul;24(7):680-4 [PMID: 9722037]
  63. Am J Respir Crit Care Med. 2001 Aug 1;164(3):396-402 [PMID: 11500339]
  64. JAMA. 2001 Oct 17;286(15):1869-78 [PMID: 11597289]
  65. Clin Microbiol Rev. 1997 Jul;10(3):444-65 [PMID: 9227861]
  66. Crit Care Med. 1999 Aug;27(8):1409-20 [PMID: 10470743]
  67. Am J Med. 1987 Sep 28;83(3B):110-6 [PMID: 3499074]
  68. Crit Care Med. 1996 May;24(5):820-6 [PMID: 8706460]
  69. Am J Respir Crit Care Med. 1999 Feb;159(2):512-8 [PMID: 9927366]
  70. Minerva Anestesiol. 1999 Jun;65(6):427-32 [PMID: 10394814]
  71. Eur J Clin Microbiol Infect Dis. 2002 May;21(5):337-52 [PMID: 12072918]
  72. J Clin Apher. 1995;10(4):171-7 [PMID: 8770708]
  73. Crit Care Med. 2004 May;32(5):1166-9 [PMID: 15190968]
  74. Chest. 1991 Sep;100(3):783-91 [PMID: 1889273]
  75. Am J Physiol. 1999 Sep;277(3 Pt 2):H1036-44 [PMID: 10484426]
  76. Am J Clin Nutr. 2001 Oct;74(4):534-42 [PMID: 11566654]
  77. Arch Intern Med. 1968 May;121(5):418-23 [PMID: 4871700]
  78. Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 1):1441-3 [PMID: 7952572]
  79. Clin Microbiol Infect. 2003 May;9(5):412-8 [PMID: 12848754]
  80. N Engl J Med. 1997 Mar 27;336(13):912-8 [PMID: 9070471]
  81. Arch Intern Med. 1991 Sep;151(9):1801-6 [PMID: 1888246]
  82. J Healthc Qual. 1998 Jan-Feb;20(1):14-9 [PMID: 10177014]
  83. Crit Care Med. 2004 Mar;32(3):691-9 [PMID: 15090949]
  84. Intensive Care Med. 2003 May;29(5):834-40 [PMID: 12684745]
  85. Nutrition. 2004 Oct;20(10):843-8 [PMID: 15474870]
  86. Arch Surg. 1999 Feb;134(2):170-6 [PMID: 10025458]
  87. JPEN J Parenter Enteral Nutr. 1993 Sep-Oct;17(5):407-13 [PMID: 8289404]
  88. Intensive Care Med. 2005 Mar;31(3):327-37 [PMID: 15605227]
  89. Ann Surg. 1986 Apr;203(4):371-8 [PMID: 3516085]
  90. Crit Care Med. 1997 Jul;25(7):1095-100 [PMID: 9233726]
  91. Ann Intern Med. 1977 Apr;86(4):456-71 [PMID: 403841]
  92. Am J Med. 1999 Oct;107(4):387-90 [PMID: 10527041]
  93. Intensive Care Med. 1999 Sep;25(9):911-9 [PMID: 10501745]
  94. Ann Pharmacother. 2001 Dec;35(12):1614-23 [PMID: 11793631]
  95. Mayo Clin Proc. 2004 Aug;79(8):992-1000 [PMID: 15301325]
  96. Am J Respir Crit Care Med. 2003 Jul 15;168(2):173-9 [PMID: 12738607]
  97. Crit Care Med. 2002 Jan;30(1):7-13 [PMID: 11902290]
  98. Ann Intern Med. 1992 Oct 1;117(7):545-53 [PMID: 1524328]
  99. N Engl J Med. 1998 Feb 5;338(6):347-54 [PMID: 9449727]
  100. Crit Care Med. 1998 Apr;26(4):748-54 [PMID: 9559614]
  101. MMWR CDC Surveill Summ. 1986;35(1):17SS-29SS [PMID: 3086701]
  102. Crit Care Med. 2000 Apr;28(4):977-83 [PMID: 10809269]
  103. Cochrane Database Syst Rev. 2000;(2):CD001090 [PMID: 10796589]
  104. J Hosp Infect. 2004 Jul;57(3):223-7 [PMID: 15236851]
  105. J Trauma. 1997 Jul;43(1):52-8; discussion 58-60 [PMID: 9253908]
  106. Am J Respir Crit Care Med. 2005 Feb 15;171(4):388-416 [PMID: 15699079]
  107. Scott Med J. 1981 Apr;26(2):115-7 [PMID: 7291971]
  108. J Intern Med. 1998 Nov;244(5):379-86 [PMID: 9845853]
  109. Am J Respir Crit Care Med. 1995 Oct;152(4 Pt 1):1387-90 [PMID: 7551400]
  110. Clin Infect Dis. 2001 Jul 15;33(2):177-86 [PMID: 11418877]
  111. Neurosignals. 2004 May-Jun;13(3):134-43 [PMID: 15067201]
  112. Postgrad Med J. 1990 Dec;66(782):1053-8 [PMID: 2084653]
  113. Crit Care Med. 2003 Aug;31(8):2228-37 [PMID: 12973184]
  114. Crit Care Med. 1991 Nov;19(11):1339-47 [PMID: 1935150]
  115. Crit Care Med. 2000 Jun;28(6):1742-6 [PMID: 10890612]
  116. N Engl J Med. 1987 Sep 10;317(11):653-8 [PMID: 3306374]
  117. Crit Care Med. 1991 Apr;19(4):463-73 [PMID: 2019131]
  118. Crit Care Med. 2000 Mar;28(3):643-8 [PMID: 10752808]
  119. Intensive Care Med. 1997 Mar;23(3):317-25 [PMID: 9083235]
  120. Ann Intern Med. 1994 Mar 1;120(5):389-95 [PMID: 8304656]
  121. Ann Intern Med. 1989 Jun 1;110(11):873-81 [PMID: 2655521]
  122. Chirurg. 1997 Aug;68(8):811-5 [PMID: 9377993]
  123. Am J Epidemiol. 1985 Feb;121(2):182-205 [PMID: 4014115]
  124. Crit Care Med. 1999 Sep;27(9):1787-93 [PMID: 10507599]
  125. J Trauma. 1999 Oct;47(4):699-703; discussion 703-5 [PMID: 10528604]
  126. Lancet. 1999 Nov 27;354(9193):1851-8 [PMID: 10584721]
  127. Crit Care Med. 1993 Oct;21(10):1466-73 [PMID: 8403954]
  128. Mayo Clin Proc. 1975 Feb;50(2):91-8 [PMID: 1090789]
  129. Lancet. 1988 Apr 9;1(8589):785-90 [PMID: 2895316]
  130. N Engl J Med. 2000 May 18;342(20):1471-7 [PMID: 10816184]
  131. Intensive Care Med. 2001;27 Suppl 1:S10-32 [PMID: 11307365]
  132. Anesth Analg. 2004 Feb;98(2):461-8 [PMID: 14742388]
  133. Crit Care Med. 2003 Jan;31(1):141-5 [PMID: 12545007]
  134. J Nurs Care Qual. 1996 Jul;10(4):18-23 [PMID: 8783541]
  135. N Engl J Med. 1996 Dec 19;335(25):1864-9 [PMID: 8948561]
  136. Crit Care Med. 1990 Oct;18(10):1073-9 [PMID: 2209033]
  137. BMJ. 1993 Aug 28;307(6903):525-32 [PMID: 8400971]
  138. JAMA. 1994 Sep 28;272(12):957-62 [PMID: 8084064]
  139. Crit Care Med. 1999 Apr;27(4):699-707 [PMID: 10321658]
  140. Clin Infect Dis. 2004 Feb 15;38(4):521-8 [PMID: 14765345]
  141. Chest. 2004 Apr;125(4):1446-57 [PMID: 15078758]
  142. Am J Med. 1996 Jul;101(1):49-53 [PMID: 8686714]
  143. BMJ. 2004 Mar 20;328(7441):668 [PMID: 14996699]
  144. Lancet. 1990 Mar 24;335(8691):704-7 [PMID: 1969068]
  145. Intensive Care Med. 2002 Jan;28(1):29-37 [PMID: 11818996]
  146. Crit Care Med. 2003 Feb;31(2):367-73 [PMID: 12576938]
  147. Ann Intern Med. 1990 Apr 1;112(7):492-8 [PMID: 2156475]
  148. Crit Care Med. 1991 Nov;19(11):1352-6 [PMID: 1935152]
  149. N Engl J Med. 1999 Sep 9;341(11):793-800 [PMID: 10477777]
  150. Crit Care Med. 2003 Feb;31(2):462-7 [PMID: 12576952]
  151. Crit Care Med. 1995 Mar;23(3):436-49 [PMID: 7874893]
  152. Am J Infect Control. 2000 Apr;28(2):197-201 [PMID: 10760228]
  153. Am J Respir Crit Care Med. 1994 Mar;149(3 Pt 1):625-9 [PMID: 8118629]
  154. Semin Respir Crit Care Med. 2003 Feb;24(1):3-22 [PMID: 16088521]
  155. Lancet. 1995 Mar 18;345(8951):669-85 [PMID: 7661937]
  156. Chest. 1989 Feb;95(2 Suppl):2S-4S [PMID: 2914516]
  157. Crit Care Med. 1997 Apr;25(4):567-74 [PMID: 9142019]
  158. Clin Infect Dis. 1998 Apr;26(4):938-41 [PMID: 9564479]
  159. Infect Control Hosp Epidemiol. 1996 Nov;17(11):746-52 [PMID: 8934244]
  160. N Engl J Med. 2000 May 4;342(18):1301-8 [PMID: 10793162]
  161. Clin Infect Dis. 1995 Nov;21(5):1103-6 [PMID: 8589128]
  162. Crit Care Med. 2003 Jul;31(7):1938-46 [PMID: 12847386]
  163. Chest. 2005 Feb;127(2):589-97 [PMID: 15706001]
  164. Chest. 2000 Apr;117(4 Suppl 2):198S-202S [PMID: 10816037]
  165. Crit Care Med. 1988 Nov;16(11):1087-93 [PMID: 3168500]
  166. Am J Infect Control. 1993 Dec;21(6):322-30 [PMID: 8122805]
  167. JAMA. 1991 May 22-29;265(20):2704-10 [PMID: 2023353]
  168. Crit Care Med. 1999 Apr;27(4):807-14 [PMID: 10321674]
  169. Intensive Care Med. 1989;15(7):424-31 [PMID: 2689493]
  170. Crit Care Med. 2004 Mar;32(3):858-73 [PMID: 15090974]
  171. Crit Care Med. 1998 Feb;26(2):315-21 [PMID: 9468171]
  172. Ann Intern Med. 1992 Apr 1;116(7):540-3 [PMID: 1543307]
  173. J Antimicrob Chemother. 1990 May;25(5):881-3 [PMID: 2098004]
  174. N Engl J Med. 1987 Sep 10;317(11):659-65 [PMID: 2888017]
  175. Burns. 1999 Nov;25(7):640-4 [PMID: 10563691]
  176. N Engl J Med. 2001 Mar 8;344(10 ):699-709 [PMID: 11236773]
  177. Intensive Care Med. 2002 Jul;28(7):877-83 [PMID: 12122525]
  178. Intensive Care Med. 2001;27 Suppl 1:S116-27 [PMID: 11307367]
  179. Surgery. 1991 Aug;110(2):303-9; discussion 309-10 [PMID: 1650036]
  180. Chest. 1993 Mar;103(3):886-95 [PMID: 8449087]
  181. JAMA. 1993 Jun 16;269(23):3024-9 [PMID: 8501845]
  182. Intensive Care Med. 2000 Mar;26 Suppl 2:S148-52 [PMID: 18470710]
  183. Am J Respir Crit Care Med. 2004 Aug 15;170(4):440-4 [PMID: 15184200]
  184. Crit Care Med. 1998 Oct;26(10 ):1639-45 [PMID: 9781719]
  185. N Engl J Med. 1995 Oct 19;333(16):1025-32 [PMID: 7675044]
  186. Clin Infect Dis. 2001 Jul 15;33(2):187-90 [PMID: 11418878]
  187. J Antimicrob Chemother. 1996 Nov;38(5):865-9 [PMID: 8961057]
  188. Antimicrob Agents Chemother. 1997 May;41(5):1127-33 [PMID: 9145881]
  189. JPEN J Parenter Enteral Nutr. 2002 May-Jun;26(3):174-81 [PMID: 12005458]
  190. JAMA. 2004 Apr 7;291(13):1603-9 [PMID: 15069048]
  191. Am J Respir Crit Care Med. 1997 Aug;156(2 Pt 1):459-65 [PMID: 9279224]
  192. BMJ. 2001 Oct 6;323(7316):773-6 [PMID: 11588077]
  193. Arch Surg. 2002 Dec;137(12):1353-9; discussion 1359 [PMID: 12470098]
  194. J Trauma. 1981 May;21(5):349-55 [PMID: 7230281]
  195. Clin Infect Dis. 2004 Jan 15;38(2):161-89 [PMID: 14699449]
  196. Chest. 2000 Jul;118(1):146-55 [PMID: 10893372]
  197. Anesth Analg. 1995 Jul;81(1):3-12 [PMID: 7598277]
  198. J Clin Microbiol. 1994 Nov;32(11):2829-31 [PMID: 7852579]
  199. N Engl J Med. 2001 Nov 8;345(19):1359-67 [PMID: 11794168]
  200. Intensive Care Med. 2004 May;30(5):844-52 [PMID: 15127196]
  201. Crit Care Med. 2000 Aug;28(8):2758-65 [PMID: 10966247]
  202. Infect Dis Clin North Am. 1993 Jun;7(2):221-34 [PMID: 8345167]
  203. Crit Care Med. 1990 Sep;18(9):935-9 [PMID: 2118443]
  204. Clin Infect Dis. 1993 Jun;16 Suppl 4:S266-72 [PMID: 8324130]
  205. Am J Med. 1996 Aug;101(2):170-6 [PMID: 8757357]
  206. Crit Care Clin. 2001 Jan;17(1):25-41 [PMID: 11219233]
  207. Arch Intern Med. 1995 Dec 11-25;155(22):2429-35 [PMID: 7503601]
  208. Crit Care Med. 1999 Dec;27(12):2609-15 [PMID: 10628598]
  209. Arch Intern Med. 1971 Jan;127(1):120-8 [PMID: 4923385]
  210. Crit Care Med. 1993 Sep;21(9):1312-8 [PMID: 8370294]
  211. Am J Med. 1985 Aug 30;79(2C):62-4 [PMID: 3898835]
  212. Crit Care Med. 1994 Oct;22(10):1568-78 [PMID: 7924367]
  213. N Engl J Med. 2001 Nov 8;345(19):1368-77 [PMID: 11794169]
  214. Am J Respir Crit Care Med. 1999 May;159(5 Pt 1):1377-82 [PMID: 10228098]
  215. J Clin Microbiol. 1998 Feb;36(2):520-5 [PMID: 9466769]
  216. Am J Respir Crit Care Med. 1999 Jul;160(1):50-6 [PMID: 10390379]
  217. N Engl J Med. 1992 Oct 8;327(15):1062-8 [PMID: 1522842]
  218. JAMA. 2001 Aug 22-29;286(8):944-53 [PMID: 11509059]
  219. Crit Care Med. 2002 Nov;30(11):2407-12 [PMID: 12441746]
  220. Br J Surg. 1983 Jan;70(1):32-5 [PMID: 6402049]
  221. Crit Care Med. 2004 Dec;32(12):2443-9 [PMID: 15599149]
  222. N Engl J Med. 1999 Feb 11;340(6):409-17 [PMID: 9971864]
  223. Pharm World Sci. 1995 Jan 27;17(1):12-6 [PMID: 7719273]
  224. Crit Care Med. 1992 Feb;20(2):304-7 [PMID: 1346591]
  225. Crit Care Med. 1992 Jun;20(6):864-74 [PMID: 1597042]
  226. J Cardiothorac Vasc Anesth. 2001 Oct;15(5):580-3 [PMID: 11687998]
  227. Crit Care Med. 2004 Nov;32(11):2199-206 [PMID: 15640631]
  228. Intensive Care Med. 2001;27 Suppl 1:S63-79 [PMID: 11307371]
  229. Am Surg. 1999 Nov;65(11):1049-53 [PMID: 10551755]
  230. Am J Med Qual. 1996 Summer;11(2):100-3 [PMID: 8704496]
  231. Crit Care Med. 1982 Jul;10(7):448-50 [PMID: 7044682]
  232. Intensive Care Med. 1984;10(4):185-92 [PMID: 6470306]
  233. Crit Care Med. 2003 Dec;31(12):2742-51 [PMID: 14668610]
  234. N Engl J Med. 2003 Apr 17;348(16):1546-54 [PMID: 12700374]
  235. N Engl J Med. 2004 May 27;350(22):2247-56 [PMID: 15163774]
  236. JPEN J Parenter Enteral Nutr. 2003 Sep-Oct;27(5):355-73 [PMID: 12971736]
  237. N Engl J Med. 1998 Mar 19;338(12):791-7 [PMID: 9504939]
  238. Crit Care Med. 2001 Aug;29(8):1526-31 [PMID: 11505120]
  239. Chest. 1989 Jul;96(1):114-9 [PMID: 2661155]
  240. J Antimicrob Chemother. 1998 Aug;42(2):233-9 [PMID: 9738842]
  241. Lancet. 1991 Oct 5;338(8771):859-62 [PMID: 1681223]
  242. BMJ. 1998 Mar 28;316(7136):961-4 [PMID: 9550953]
  243. Pediatr Infect Dis J. 1996 Dec;15(12):1107-12 [PMID: 8970221]
  244. Ann Intern Med. 1990 Oct 1;113(7):495-500 [PMID: 2393205]
  245. Am J Med. 2003 Nov;115(7):529-35 [PMID: 14599631]
  246. Circulation. 2003 May 13;107(18):2313-9 [PMID: 12732600]
  247. Intensive Care Med. 2001 Oct;27(10):1584-91 [PMID: 11685298]
  248. Intensive Care Med. 1999 Aug;25(8):781-9 [PMID: 10447534]
  249. JAMA. 2002 Dec 11;288(22):2827-35 [PMID: 12472324]
  250. Eur J Cardiothorac Surg. 1998 May;13(5):533-9; discussion 539-40 [PMID: 9663534]
  251. Intensive Care Med. 2004 Jul;30(7):1276-91 [PMID: 15103461]
  252. Ann Surg. 1999 Apr;229(4):467-77 [PMID: 10203078]
  253. N Engl J Med. 2001 Aug 23;345(8):568-73 [PMID: 11529210]
  254. Crit Care Med. 2002 Aug;30(8):1686-92 [PMID: 12163777]
  255. Q J Med. 1987 May;63(241):427-40 [PMID: 3310074]
  256. J Clin Microbiol. 1998 Jul;36(7):1923-6 [PMID: 9650937]
  257. Anesthesiology. 2002 Mar;96(3):576-82 [PMID: 11873030]
  258. Crit Care Med. 2003 May;31(5):1394-8 [PMID: 12771608]
  259. Crit Care Med. 1999 Jun;27(6):1100-4 [PMID: 10397212]
  260. Kidney Int. 2001 Sep;60(3):1154-63 [PMID: 11532112]
  261. Am J Med. 1991 Sep 16;91(3B):131S-137S [PMID: 1928154]
  262. Intensive Care Med. 1997 Feb;23(2):187-95 [PMID: 9069004]
  263. Crit Care Med. 1999 Aug;27(8):1478-85 [PMID: 10470753]
  264. Ann Hematol. 2003 Oct;82 Suppl 2:S105-17 [PMID: 13680173]
  265. Scand J Infect Dis. 2002;34(7):520-8 [PMID: 12195878]
  266. Jt Comm J Qual Improv. 1996 Jul;22(7):457-67 [PMID: 8858417]
  267. Crit Care Med. 1999 Oct;27(10):2166-71 [PMID: 10548200]
  268. Am J Respir Crit Care Med. 1999 Feb;159(2):439-46 [PMID: 9927355]
  269. Am J Respir Crit Care Med. 1998 Sep;158(3):908-16 [PMID: 9731025]
  270. Intensive Care Med. 1990;16(5):307-11 [PMID: 2212255]
  271. Crit Care Med. 1997 Mar;25(3):399-404 [PMID: 9118653]
  272. Crit Care Med. 2001 Nov;29(11):2075-80 [PMID: 11700398]
  273. Eur J Clin Microbiol Infect Dis. 1997 May;16(5):337-45 [PMID: 9228472]
  274. Am J Respir Crit Care Med. 2002 Oct 15;166(8):1029-37 [PMID: 12379544]
  275. JAMA. 2004 Nov 17;292(19):2379-87 [PMID: 15547166]
  276. Anesth Analg. 1994 Apr;78(4):772-4 [PMID: 8135399]
  277. J Antimicrob Chemother. 2001 Aug;48(2):209-17 [PMID: 11481290]
  278. Crit Care Med. 2001 Mar;29(3):487-93 [PMID: 11373409]
  279. J Clin Pathol. 1999 Mar;52(3):165-72 [PMID: 10450173]
  280. N Engl J Med. 1999 Sep 9;341(11):785-92 [PMID: 10477776]
  281. CMAJ. 2004 Jan 20;170(2):197-204 [PMID: 14734433]
  282. Chest. 2000 Apr;117(4 Suppl 2):191S-194S [PMID: 10816035]
  283. Kidney Int Suppl. 1998 May;66:S138-41 [PMID: 9573591]
  284. Clin Infect Dis. 1996 May;22(5):766-77 [PMID: 8722929]
  285. Crit Care Med. 1991 Dec;19(12):1583-7 [PMID: 1959379]
  286. Clin Infect Dis. 1997 Apr;24(4):584-602 [PMID: 9145732]
  287. N Engl J Med. 1992 Feb 27;326(9):594-9 [PMID: 1734249]
  288. Intensive Care Med. 2002 Feb;28(2):108-21 [PMID: 11907653]
  289. Lancet. 2003 Sep 27;362(9389):1011-6 [PMID: 14522530]
  290. Chest. 1996 Mar;109(3):765-72 [PMID: 8617089]
  291. Am J Respir Crit Care Med. 2000 Aug;162(2 Pt 1):505-11 [PMID: 10934078]
  292. Chest. 2000 Apr;117(4 Suppl 2):195S-197S [PMID: 10816036]

MeSH Term

Delivery of Health Care, Integrated
Germany
Humans
Practice Guidelines as Topic
Practice Patterns, Physicians'
Sepsis

Word Cloud

Created with Highcharts 10.0.0sepsisSepsis000GermantherapyseverecareguidelinesSocietyinhabitants100approximatelyintensivediagnosisdevelopmentrecentsurveyconductedpubliclyfundedCompetenceNetworkSepNetrevealsand/orsepticshockoccurs7511079116Germanyannuallyillnessresponsible60deathsrangesthirdfrequentcausedeathacutemyocardialinfarctionDirectcostspatientsaloneamount177billioneurosmeans30%budgetusedtreatHowevernowexistThereforeinitiatedbasedinternationalrecommendationsInternationalForumISFSurvivingCampaignSSCtakeaccountstructureorganizationhealthsystemPrioritygivenfollowingguidelinetopics:bpreventionccausativedsupportiveeadjunctiveprocesscarefullyplannedstrictlyadheredrequirementsWorkingGroupScientificMedicalSocietiesAWMF[DiagnosisGuidelinesIncInterdisciplinaryIntensiveEmergencyMedicine]

Similar Articles

Cited By