The 2004 guidelines of the Surviving Sepsis Campaign (SSC)1 for the management of severe sepsis and septic shock included recommendations about glucose control, the use of recombinant human activated protein C (rhAPC) and intravenous steroid replacement, based on original trials by van den Berghe and Annane in 2001 and Bernard (PROWESS) in 2002. In 2008, the SSC revised the international guidelines2 to reflect the results of recent trials (VISEP, CORTICUS, ADDRESS, RESOLVE). Some of these studies completely or partially contradicted results of the earlier trials. We conducted a questionnaire survey of all intensive care units (ICUs) in Scotland six months after publication of the 2008 SSC guidelines to assess current practice.
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