Surviving Sepsis After Burn Campaign

David G Greenhalgh; David M Hill; David M Burmeister; Eduardo I Gus; Heather Cleland; Alex Padiglione; Dane Holden; Fredrik Huss; Michelle S Chew; John C Kubasiak; Aidan Burrell; William Manzanares; María Chacón Gómez; Yuya Yoshimura; Folke Sjöberg; Wei-Guo Xie; Paula Egipto; Athina Lavrentieva; Arpana Jain; Ariel Miranda-Altamirano; Ed Raby; Ignacio Aramendi; Soman Sen; Kevin K Chung; Renata Jennifer Quintana Alvarez; Chunmao Han; Asako Matsushima; Moustafa Elmasry; Yan Liu; Carlos Segovia Donoso; Alberto Bolgiani; Laura S Johnson; Luiz Philipe Molina Vana; Rosario Valdez Duval de Romero; Nikki Allorto; Gerald Abesamis; Virginia Nuñez Luna; Alfredo Gragnani; Carolina Bonilla González; Hugo Basilico; Fiona Wood; James Jeng; Andrew Li; Mervyn Singer; Gaoxing Luo; Tina Palmieri; Steven Kahn; Victor Joe; Robert Cartotto

doi:10.1016/j.burns.2023.05.003

Surviving Sepsis After Burn Campaign

Burns. 2023 Nov;49(7):1487-1524. doi: 10.1016/j.burns.2023.05.003. Epub 2023 May 6.

Authors

David G Greenhalgh¹, David M Hill², David M Burmeister³, Eduardo I Gus⁴, Heather Cleland⁵, Alex Padiglione⁵, Dane Holden⁵, Fredrik Huss⁶, Michelle S Chew⁷, John C Kubasiak⁸, Aidan Burrell⁹, William Manzanares¹⁰, María Chacón Gómez¹¹, Yuya Yoshimura¹², Folke Sjöberg⁷, Wei-Guo Xie¹³, Paula Egipto¹⁴, Athina Lavrentieva¹⁵, Arpana Jain¹⁶, Ariel Miranda-Altamirano¹⁷, Ed Raby¹⁸, Ignacio Aramendi¹⁹, Soman Sen²⁰, Kevin K Chung³, Renata Jennifer Quintana Alvarez²¹, Chunmao Han²², Asako Matsushima²³, Moustafa Elmasry²⁴, Yan Liu²⁵, Carlos Segovia Donoso²⁶, Alberto Bolgiani²⁷, Laura S Johnson²⁸, Luiz Philipe Molina Vana²⁹, Rosario Valdez Duval de Romero³⁰, Nikki Allorto³¹, Gerald Abesamis³², Virginia Nuñez Luna³³, Alfredo Gragnani²⁹, Carolina Bonilla González³⁴, Hugo Basilico³⁵, Fiona Wood³⁶, James Jeng³⁷, Andrew Li⁵, Mervyn Singer³⁸, Gaoxing Luo³⁹, Tina Palmieri²⁰, Steven Kahn⁴⁰, Victor Joe³⁷, Robert Cartotto⁴¹

Affiliations

¹ Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA. Electronic address: [email protected].
² Department of Clinical Pharmacy & Translational Scre have been several studies that have evaluatedience, College of Pharmacy, University of Tennessee, Health Science Center; Memphis, TN, USA.
³ Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
⁴ Division of Plastic & Reconstructive Surgery, The Hospital for Sick Children; Department of Surgery, University of Toronto, Toronto, Canada.
⁵ Department of Surgery, Monash University and Alfred Hospital, Melbourne, Australia.
⁶ Department of Surgical Sciences, Plastic Surgery, Uppsala University/Burn Center, Department of Plastic and Maxillofacial Surgery, Uppsala University Hospital, Uppsala, Sweden.
⁷ Department of Anaesthesia and Intensive Care, Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
⁸ Department of Surgery, Loyola University Medical Center, Maywood, IL, USA.
⁹ Department of Epidemiology and Preventative Medicine, Monash University and Alfred Hospital, Intensive Care Research Center (ANZIC-RC), Melbourne, Australia.
¹⁰ Department of Critical Care Medicine, Universidad de la República (UdelaR), Montevideo, Uruguay.
¹¹ Division of Intensive Care and Critical Medicine, Centro Nacional de Investigacion y Atencion de Quemados (CENIAQ), National Rehabilitation Institute, LGII, Mexico.
¹² Department of Emergency and Critical Care Medicine, Hachinohe City Hospital, Hachinohe, Japan.
¹³ Institute of Burns, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan, China.
¹⁴ Centro Hospitalar e Universitário São João - Burn Unit, Porto, Portugal.
¹⁵ A-ICU, Burn-ICU, Papanikolaou Hospital, Thessaloniki, Greece.
¹⁶ Arizona Burn Center, Phoenix, AZ, USA.
¹⁷ Hospital Civil de Guadalajara, Guadalajara, Mexico.
¹⁸ Infectious Diseases Department, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
¹⁹ Centro Nacional de Quemados. Montevideo, Uruguay.
²⁰ Department of Burns, Shriners Children's Northern California and Department of Surgery, University of California, Davis, Sacramento, CA, USA.
²¹ Pediatric Burn Center, Santiago, Dominican Republic.
²² Department of Burn and Wound Repair, Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, China.
²³ Department of Emergency and Critical Care, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
²⁴ Department of Hand, Plastic Surgery and Burns, Linköping University, Linköping, Sweden.
²⁵ Department of Burn, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
²⁶ Intensive Care Unit for Major Burns, Mutual Security Clinical Hospital, Santiago, Chile.
²⁷ Department of Surgery, Deutsches Hospital, Buenos Aires, Argentina.
²⁸ Department of Surgery, Emory University School of Medicine and Grady Health System, Georgia.
²⁹ Disciplina de Cirurgia Plastica da Escola Paulista de Medicina da Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
³⁰ Infectious Diseases Department, Pearl F. Ort Burn Unit, Santo Domingo, Dominican Republic.
³¹ Grey's Hospital Pietermaritzburg Metropolitan Burn Service, University of KwaZulu Natal, Pietermaritzburg, South Africa.
³² Alfredo T. Ramirez Burn Center, Division of Burns, Department of Surgery, University of Philippines Manila - Philippine General Hospital, Manila, Philippines.
³³ Unidad Michou y Mau Xochimilco for Burnt Children, Secretaria Salud Ciudad de México, Mexico.
³⁴ Department of Pediatrics and Intensive Care, Pediatric Burn Unit, Clinical Studies and Clinical Epidemiology Division, Fundación Santa Fe de Bogotá, Bogotá, Colombia.
³⁵ Intensive Care Area - Burn Unit - Pediatric Hospital "Prof. Dr. Juan P. Garrahan", Buenos Aires, Argentina.
³⁶ Department of Surgery, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
³⁷ Department of Surgery, University of California, Irvine, CA, USA.
³⁸ Department of Intensive Care Medicine, University College London, London, United Kingdom.
³⁹ Institute of Burn Research, Southwest Hospital, Army (Third Military) Medical University, Chongqing, China.
⁴⁰ The South Carolina Burn Center, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
⁴¹ Department of Surgery, Sunnybrook Medical Center, Toronto, Ontario, Canada.

PMID: 37839919
DOI: 10.1016/j.burns.2023.05.003

Abstract

Introduction: The Surviving Sepsis Campaign was developed to improve outcomes for all patients with sepsis. Despite sepsis being the primary cause of death after thermal injury, burns have always been excluded from the Surviving Sepsis efforts. To improve sepsis outcomes in burn patients, an international group of burn experts developed the Surviving Sepsis After Burn Campaign (SSABC) as a testable guideline to improve burn sepsis outcomes.

Methods: The International Society for Burn Injuries (ISBI) reached out to regional or national burn organizations to recommend members to participate in the program. Two members of the ISBI developed specific "patient/population, intervention, comparison and outcome" (PICO) questions that paralleled the 2021 Surviving Sepsis Campaign [1]. SSABC participants were asked to search the current literature and rate its quality for each topic. At the Congress of the ISBI, in Guadalajara, Mexico, August 28, 2022, a majority of the participants met to create "statements" based on the literature. The "summary statements" were then sent to all members for comment with the hope of developing an 80% consensus. After four reviews, a consensus statement for each topic was created or "no consensus" was reported.

Results: The committee developed sixty statements within fourteen topics that provide guidance for the early treatment of sepsis in burn patients. These statements should be used to improve the care of sepsis in burn patients. The statements should not be considered as "static" comments but should rather be used as guidelines for future testing of the best treatments for sepsis in burn patients. They should be updated on a regular basis.

Conclusion: Members of the burn community from the around the world have developed the Surviving Sepsis After Burn Campaign guidelines with the goal of improving the outcome of sepsis in burn patients.

Keywords: Burns; Infection; Prevention; Resuscitation; Sepsis; Septic shock.

MeSH terms

Burns* / complications
Burns* / therapy
Critical Care
Fluid Therapy
Humans
Sepsis* / therapy
Shock, Septic* / therapy