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• W3201857588 abstract "We thank Douglas et al for their interest in our work. As noted in our manuscript, we used a multidisciplinary and multiorganizational approach to address the opportunities and limits of current guidelines on sepsis care.1Yealy D.M. Mohr N.M. Shapiro N.I. et al.Early care of adults with suspected sepsis in the emergency department and out-of-hospital environment: a consensus-based task force report. Ann Emerg Med.https://doi.org/10.1016/j.annemergmed.2021.02.006Google Scholar We specifically did not create a comprehensive and graded series of recommendations on early care, seeking instead to identify key concerns in current recommendations and care quality measures. We sought to address current controversies and help inform future guideline development and quality measures that bridge all acute care settings. Ongoing updates are important along with unifying efforts across disciplines and organizations that recognize the many settings in which sepsis care must be delivered. We all can do better together. We also agree with Douglas et al2Douglas I.S. Alapat P.M. Corl K.A. et al.Fluid response evaluation in sepsis hypotension and shock: a randomized clinical trial.Chest. 2020; 158: 1431-1445Abstract Full Text Full Text PDF PubMed Scopus (46) Google Scholar that dynamic fluid response assessment in septic shock has promise and that the FRESH trial was underpowered to show a clear patient-relevant benefit. Other dynamic fluid assessment techniques have also shown promise, and all had a careful review by our experts. We affirm our view that dynamic fluid responsiveness may be useful in emergency sepsis care; however, we do not currently recommend its routine use. Our conclusion aligns closely with that of Douglas et al2Douglas I.S. Alapat P.M. Corl K.A. et al.Fluid response evaluation in sepsis hypotension and shock: a randomized clinical trial.Chest. 2020; 158: 1431-1445Abstract Full Text Full Text PDF PubMed Scopus (46) Google Scholar in the FRESH manuscript, saying the approach “may improve outcomes for patients with septic shock….” We look forward to new evidence to better inform future sepsis care. Dynamic Fluid Response Measures to Guide Early Care of Adults With Suspected Sepsis in the Emergency Department and Out-of-Hospital EnvironmentAnnals of Emergency MedicineVol. 78Issue 4PreviewWe read with interest the article by Yealy et al1 titled “Early Care of Adults With Suspected Sepsis in the Emergency Department and Out-of-Hospital Environment: A Consensus-Based Task Force Report,” and we commend the authors on their generally comprehensive and timely report. While the consensus development process leverages methodological rigor, it is inherently susceptible to rapid obsolescence as the evidence base evolves. A potential consequence is a delay in the dissemination and implementation of high-quality evidence. Full-Text PDF Early Care of Adults With Suspected Sepsis in the Emergency Department and Out-of-Hospital Environment: A Consensus-Based Task Force ReportAnnals of Emergency MedicineVol. 78Issue 1PreviewSepsis is a major cause of hospital death in the United States (US)1 and is associated with over 850,000 annual emergency department visits.2 Despite advances in care, patients with serious infection continue to have a high inpatient mortality rate, reaching 20% or more in some settings. This makes sepsis and septic shock one of the highest mortality conditions treated in the ED. Additionally, many survivors never fully recover, and instead, long-term morbidities, chronic critical illness, or post-intensive care syndrome develops in them. Full-Text PDF" @default.
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• W3201857588 date "2021-10-01" @default.
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• W3201857588 title "In Reply to Ivor Douglas Letter to the Editor 2021-1053" @default.
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• W3201857588 doi "https://doi.org/10.1016/j.annemergmed.2021.05.028" @default.
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