Die neue internationale Sepsis-Leitlinie der Surviving Sepsis Campaign 2021

Die Surviving Sepsis Campaign (SSC) veröffentlichte im Oktober 2021 eine Aktualisierung der zuletzt im Jahr 2016 überarbeiteten SSC-Leitlinie zur Diagnostik und Behandlung der Sepsis und des septischen Schocks bei Erwachsenen. Der Artikel fasst die aktuellen Empfehlungen zur Akuttherapie praxisrelevant zusammen und stellt die Unterschiede zur vorherigen Version und der aktuellen S3-Leitlinie der Deutschen Sepsis-Gesellschaft heraus.

Abstract

The new Surviving Sepsis Campaign (SSC) guideline was substantially revised in 2021. These updated recommendations are intended to guide intensivists in providing adequate care to adult patients with sepsis or septic shock. In particular, the current SSC guideline emphasizes early recognition and stringent management in the first hours after the onset of sepsis. In particular, the implementation of acute interventions should help to improve the chances of survival of sepsis patients.

This article summarizes the most important recommendations for acute therapy and presents them as a comparative overview to the previous SSC guideline and the German S3 guideline. This should allow the reader to adopt the knowledge from the new guideline into clinical practice as quickly as possible in order to improve the quality of treatment of patients with sepsis or septic shock.

Kernaussagen

• Zur Frühkennung einer Sepsis sollte der qSOFA-Score nicht als alleiniges Screening-Instrument verwendet werden. Die SIRS-Kriterien sowie der NEWS- und MEWS-Score stellen sinnvolle Erweiterungen dar.

• Bei Gabe des initialen Flüssigkeitsbolus sollte ein Assessment auf das Vorliegen einer Hypoperfusion, unter anderem mithilfe der Rekapillarisierungszeit, durchgeführt werden.

• Zur hämodynamischen Stabilisierung sollten balancierte Vollelektrolytlösungen verabreicht werden.

• Bei geringer Wahrscheinlichkeit für eine Sepsis und ohne Zeichen des septischen Schocks ist es vertretbar, weitere Diagnostik durchzuführen und Antibiotika innerhalb eines 3-h-Zeitrahmens zu verabreichen.

• Von extrakorporalen Blutreinigungstechniken sowie der Gabe von Vitamin C oder Levosimendan sollte in der Sepsis abgesehen werden.

Schlüsselwörter

Sepsis - septischer Schock - Leitlinie - Surviving-Sepsis-Campaign - SSC

Keywords

sepsis - septic shock - guideline - Surviving-Sepsis-Campaign - SSC

Publication History

Article published online:
19 May 2022

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