{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:38:29Z","timestamp":1777883909778,"version":"3.51.4"},"reference-count":11,"publisher":"AACN Publishing","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Surviving Sepsis Campaign guidelines were last updated in 2021, with many recommendations based on evidence of low or very low quality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess practices and opinions regarding hemodynamic optimization in patients with sepsis and the adoption of updated recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional survey of members of the Society of Critical Care Medicine addressed practices and opinions regarding initial fluid resuscitation and thresholds for initiation of adjunctive vasopressors and corticosteroids. Responses were analyzed for patients with vs without obesity and stratified by respondent profession and experience. The primary outcome was guideline-suggested use of ideal body weight to dose initial fluids in patients without obesity. Variables were compared using the \u03c72 test, with P &amp;lt; .05 indicating statistical significance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Completed questionnaires were returned by 485 society members. In patients without obesity, 17% of respondents dosed initial resuscitation fluids by using ideal body weight, whereas 80% and 3% used total and adjusted body weights, respectively. Respondents with more than 20 years in practice were more likely to use ideal body weight (20%) than those with less than 5 years (12%) (P = .008). In terms of opinions, 57% of respondents preferred use of total body weight in patients without obesity, whereas 37% and 6% preferred ideal body weight and adjusted body weight, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study showed differences in practices based on experience. Clinicians\u2019 opinions aligned more closely with guideline statements than did actual practices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ajcc2026584","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T02:03:49Z","timestamp":1777601029000},"page":"191-198","source":"Crossref","is-referenced-by-count":0,"title":["Current Practices and Opinions Related to Hemodynamic Optimization in Patients With Sepsis: An International Survey"],"prefix":"10.4037","volume":"35","author":[{"given":"Alexander J.","family":"Ruehman","sequence":"first","affiliation":[{"name":"Alexander J. Ruehman is a pharmacist, University of Maryland Medical Center, Baltimore."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Covington","sequence":"additional","affiliation":[{"name":"Emma Covington is a pharmacist, University of Virginia Health, Charlottesville."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trisha N.","family":"Branan","sequence":"additional","affiliation":[{"name":"Trisha N. Branan is a clinical professor, Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Athens."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. Anthony","family":"Hawkins","sequence":"additional","affiliation":[{"name":"W. Anthony Hawkins is a clinical associate professor, Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, and Department of Pharmacology and Toxicology, Medical College of Georgia at Augusta University, Albany."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Susan E. Smith is an associate professor, Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Athens."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2471","reference":[{"issue":"8","key":"2026043022031568400_b1-0350191","doi-asserted-by":"publisher","first-page":"1552","DOI":"10.1007\/s00134-020-06151-x","article-title":"Incidence and mortality of hospital- and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis","volume":"46","author":"Fleischmann-Struzek","year":"2020","journal-title":"Intensive Care Med"},{"issue":"10219","key":"2026043022031568400_b2-0350191","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"issue":"11","key":"2026043022031568400_b3-0350191","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1007\/s00134-021-06506-y","article-title":"Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2021","volume":"47","author":"Evans","year":"2021","journal-title":"Intensive Care Med"},{"issue":"3","key":"2026043022031568400_b4-0350191","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1007\/s00134-017-4683-6","article-title":"Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock: 2016","volume":"43","author":"Rhodes","year":"2017","journal-title":"Intensive Care Med"},{"key":"2026043022031568400_b5-0350191","unstructured":"The Joint Commission\n          . Specifications Manual for National Hospital Inpatient Quality Measures. 2018. Accessed September 10, 2025. https:\/\/manual.jointcommission.org\/releases\/archive\/pdf_archive\/TJC_v2018A1.pdf"},{"key":"2026043022031568400_b6-0350191","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1186\/1748-5908-4-54","article-title":"Why don\u2019t physicians adhere to guideline recommendations in practice? an analysis of barriers among Dutch general practitioners","volume":"4","author":"Lugtenberg","year":"2009","journal-title":"Implement Sci"},{"issue":"12","key":"2026043022031568400_b7-0350191","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1001\/jama.286.12.1461","article-title":"Validity of the Agency for Healthcare Research and Quality clinical practice guidelines: how quickly do guidelines become outdated?","volume":"286","author":"Shekelle","year":"2001","journal-title":"JAMA"},{"issue":"3","key":"2026043022031568400_b8-0350191","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1080\/17425255.2018.1440287","article-title":"Obesity and drug pharmacology: a review of the influence of obesity on pharmacokinetic and pharmacodynamic parameters","volume":"14","author":"Smit","year":"2018","journal-title":"Expert Opin Drug Metab Toxicol"},{"key":"2026043022031568400_b9-0350191","unstructured":"Society of Critical Care Medicine\n          . Frequently asked questions. Accessed April 30, 2025. https:\/\/sccm.org\/about-sccm\/frequently-asked-questions"},{"issue":"8","key":"2026043022031568400_b10-0350191","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.3390\/healthcare10081445","article-title":"A survey of tele-critical care state and needs in 2019 and 2020 conducted among the members of the Society of Critical Care Medicine","volume":"10","author":"Laudanski","year":"2022","journal-title":"Healthcare (Basel)"},{"issue":"4","key":"2026043022031568400_b11-0350191","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1097\/ANS.0000000000000263","article-title":"Implementation of clinical practice guidelines in the health care setting: a concept analysis","volume":"42","author":"Beauchemin","year":"2019","journal-title":"ANS Adv Nurs Sci"}],"container-title":["American Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/35\/3\/191\/170082\/191.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/35\/3\/191\/170082\/191.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T02:03:51Z","timestamp":1777601031000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article\/35\/3\/191\/33018\/Current-Practices-and-Opinions-Related-to"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,1]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ajcc2026584","relation":{},"ISSN":["1062-3264","1937-710X"],"issn-type":[{"value":"1062-3264","type":"print"},{"value":"1937-710X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,1]]}}}