Practice parameters for hemodynamic support of sepsis in adult patients insepsis

Objective: To present guidelines for hemodynamic support of adult patients with sepsis, Participants: An international task force of nine experts in disciplines re lated to critical care medicine was convened from the membership of the Soc iety of Critical Care Medicine. Evidence: Review of published literature and expertise and personal experie nce of task force. The strength of evidence of human studies was classified according to study design and scientific value. Consensus Process: The task force met several times in per son and communic ated by electronic mail to identify the pertinent literature and arrive at consensus recommendations. Consideration was given to the relationship betw een the weight of scientific evidence and the experts' opinions, Draft docu ments were composed and debated by the task force until consensus was reach ed, The strength of recommendations was graded according to evidenced-based guidelines, Conclusions: The panel formulated an underlying approach to the hemodynamic support of sepsis, Hemodynamic therapies should be titrated to specific an d definable endpoints, The effects of therapy should be assessed by monitor ing a combination of parameters of global and regional perfusion, Using thi s approach, the panel made specific recommendations for fluid resuscitation , vasopressor therapy, and inotropic therapy of septic patients.