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SSC 2021 Guidelines
SSC 2021 Guidelines
CVS
Renal
SBP < 90mmHg Respiratory
Urine output <
MAP < 70mmHg 0.5ml/kg/hr for 1 hr PaO2/FiO2 <250
Hematologic
Platelet count <80,000 Unexplained
50% decrease from metabolic acidosis
highest value
• Septic shock : Sepsis with hypotension for atleast 1 hr
despite fluid resuscitation
OR
Need for vasopressors to maintain SBP >90mmHg or
MAP >70mmHg
• Refractory septic shock : Septic shock that lasts for >1hr
and does not respond to fluid or pressor administration.
10. For adults with sepsis or septic shock who re- quire
ICU admission, we suggest admitting the patients to
the ICU within 6 hr.
INFECTION
Recommendations 2021
58. For adults with septic shock and an ongoing “We suggest against using IV hydrocortisone to treat
requirement for vasopressor therapy we sug- gest septic shock patients if adequate fluid resuscitation
using IV corticosteroids. and vasopressor therapy are able to restore he-
modynamic stability (see goals for Initial
Resuscitation). If this is not achievable, we suggest IV
hydrocortisone at a dose of 200 mg/day.”
59. For adults with sepsis or septic shock we sug- gest NEW from previous:
against using polymyxin B hemoperfusion. “We make no recommendation regarding the use of
blood purification techniques”
85. For adults with sepsis and septic shock and their
families, we suggest using a critical care transition
program, compared with usual care, upon transfer to
the floor.
Recommendations 2021 Changes From 2016 Recommendations