In this revision of the SSC bundles, the 3-hour and 6-hour bundles have been combined into a single “Hour-1 Bundle” with the explicit intention of beginning resuscitation and management immediately. This new sepsis “Hour-1 Bundle” should be introduced to staff in the emergency department (ED), wards, and intensive care unit as the next iteration of ever-improving tools in the care of patients with sepsis and septic shock as we all work to lessen the global burden of sepsis.
ESICM is releasing the The Surviving Sepsis Campaign Bundle: 2018 update (Free Access) in our official journal Intensive Care Medicine. Additionally, we have prepared a short animation video to highlight the five steps of the Hour-1 Bundle that healthcare providers should begin as soon as sepsis is recognised:
In this single-center prospective study, Alessandro Marchioni et al. conclude that early and noninvasive ultrasound assessment of diaphragmatic dysfunction during severe acute exacerbations of COPD is reliable and accurate in identifying patients at major risk for noninvasive ventilation failure and worse prognosis.
Strained ICU capacity represents a fundamental supply-demand mismatch in ICU resources. In this systematic review, Oleksa G. Rewa et al. identify and characterize 16 indicators of strained ICU capacity across the spectrum of healthcare quality domains.
The timing of initiation of RRT in severe AKI remains controversial, with early initiation resulting in unnecessary therapy for some patients, while expectant therapy may delay RRT for other patients. In this multicenter pilot study, Nuttha Lumlertgul et al. conclude that FST appears to be feasible and effective in identifying patients for randomization to different RRT initiation times.