Others commenters, however, were less enthusiastic about the new definitions and criteria. Intensivist Flavia Machado, MD, PhD (@FlaviaSepsis), tweeted a JPEG summing up her feelings: “Keep Calm and Don’t Change Sepsis Definitions.” In a link to a statement from the Latin American Sepsis Institute (LASI), Dr. Machado and others in low- and middle-resource settings expressed concern that the new definitions might not have enough sensitivity. The 19 coauthors also expressed concern that the definitions were made without consulting important stakeholder organizations such as LASI. Last year, ACEP lodged a similar complaint regarding the lack of emergency medicine representation on the task force that developed the new definitions.

That being said, uptake of the definitions online seemed brisk and enthusiastic. On his free online medical calculator, MDcalc, Graham Walker, MD (@grahamwalker), rolled out a new SOFA and qSOFA score tool within days of the announcement. Salim Rezaie, MD (@srrezaie), used the relatively new Twitter poll function to ask the #FOAMed community, “Is Sepsis-3/qSOFA/SOFA ready for primetime clinical use?” Out of 139 responses, 22 percent said, “Yes, SIRS is Dead,” 28 percent said, “No, SIRS is NOT dead,” while 50 percent said, “Maybe, Use SIRS & SOFA.” Not a bad start for five days after liftoff.

Dr. Westafer and I also released a 20-minute summary of the definitions on our podcast, FOAMcast. In that episode, we cover how the definitions were made as well as some strengths, weaknesses, criticisms, and defenses of the new definitions.

The conversation will no doubt continue online and likely in person at the 36th International Symposium on Intensive Care and Emergency Medicine, March 15–18, in Brussels, Belgium, so watch for tweets coming from #ISICEM16.

Reference

1. Singer M, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3). JAMA. 2016;315(8):801-810.