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The end of the line for the Surviving Sepsis Campaign, but not for early goal-directed therapy

The Surviving Sepsis Campaign (SSC) was heralded at the 15th annual congress of the European Society of Intensive Care Medicine in Barcelona in 2002 and launched in 2004. The intention was to reduce sepsis mortality by 25% within 5 years by the implementation of evidence-based guidelines—the resuscitation and management bundles . The third and final phase came to a close with the publication of the results of the performance improvement programme in December 2009.1 Voluntarily submitted data were analysed on 15 022 patients with severe sepsis and septic shock. The outcomes evaluated included compliance with performance measures and hospital mortality.

Compliance with the bundles increased significantly from the start of the study to the end of the final quarter, while mortality fell from 37% to 30.8% during the 2-year study period. Factors associated with increased mortality were pre-existing organ failures, pneumonia as the source of sepsis and a non-emergency department presentation. Early interventions found to be independently associated with survival benefit were timely antibiotics and blood cultures prior to administration (p=0.0001). Measurement of blood lactate was non-contributory to outcome in the whole patient population; the risk-adjusted OR for …