Haemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference, 13 October 2005, Paris, France

Thierry Pottecher,Sylvie Calvat,Jacques Durand-Gasselin,Hervé Dupont,Patrick Gerbeaux

doi:10.1186/cc4965

Abstract

We present a consensus report from the SFAR/SLRF (Société Française d'Anesthésie et de Réanimation/Société de Réanimation de Langue Française) Consensus Conference, held on 13 October 2005 in Paris, France. The consensus report made recommendations on five topics relevant to the treatment of circulatory failure in sepsis and its underlying rationale. These topics are as follows: therapeutic goals of haemodynamic support in sepsis; goals of fluid resuscitation (including transfusion); role of inotropes and vasoactive drugs; role of other treatments; and treatment strategy. This report is reproduced from a translation of the original in Annales Francaises of Anesthésie and Réanimation.

Highlights

This consensus report is reproduced from a translation of the original [1], which was published in French
It is limited to the management of haemodynamic consequences of severe sepsis
The scientific value of studies is divided into five levels as follows: level 1 includes large randomized controlled trials with clear results, and low risk for false positives (α error) or false negatives (β error); level 2 includes smaller randomized controlled trials with less clear results, and medium to high risk for false positives (α error) or false negatives (β error); level 3 includes nonrandomized studies with contemporaneous controls; level 4 includes nonrandomized studies with historical controls or expert opinion; and level 5 includes case reports, noncomparative studies, or expert opinion

Summary

Introduction

This consensus report is reproduced from a translation of the original [1], which was published in French. Correction of arterial hypotension increases oxygen delivery to tissues and improves the prognosis of patients with severe sepsis; early and aggressive fluid loading is recommended (grade B). Treatment with positive inotropes is indicated in these cases (grade B). Specific differences in paediatric patients Severe sepsis in children is more often characterized by cardiac failure and hypovolaemia, which responds well to fluid loading.

Results

Conclusion