Surviving Sepsis Campaign Bundles Adherence and Their Limits in Surgical Patients with Septic Shock in an ICU.
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Date
2013-01
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Abstract
Aims: The Surviving Sepsis Campaign (SSC) guidelines aimed to reduce heterogeneity
of conventional therapy and mortality. The present study was performed in septic shock
to describe the adherence to the 2008 SSC guidelines, confounding factors, and
limitations.
Study Design: Prospective observational study.
Place and Duration of Study: Clinic of Anaesthesiology, University Hospital Medical
School, and Clinical Economics at the Institute of History, Philosophy and Ethics in
Medicine, University of Ulm, between January 2008 and June 2009.
Methodology: The adherence to 36 items of the 6-hour and 24-hour bundles of the
2008 SSC guidelines was investigated in 98 surgical patients with septic shock.
Results: The adherence to the 36 items varied between 0% and 95%. Besides the
categories “adherent“ and “nonadherent“, additional categories “partially adherent“, “notapplicable“
and “unknown“ were used. None of the single items alone was essential for
survival. Patients with septic shock on admission (n=68) had significantly higher SOFA
scores (degree of organ dysfunctions) compared to patients developing septic shock in
the ICU (n = 30).
Conclusion: As many confounders are limiting the adherence to complex guidelines, the complete adherence will hardly be possible in severe diseases such as septic
shock. Our results suggest that efforts associated with early diagnosis and active
encouragement outside the ICU are necessary to improve applicability and adherence
to the SSC guidelines in patients with septic shock in order to reduce the time lag of
diagnosis and treatment, which may be reached by focusing on few essential points.
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Keywords
Critical illness, intensive care units, guideline adherence, sepsis bundles, shock septic/mortality/therapy
Citation
Weiss Manfred, Lautenschlager Florian, Porzsolt Franz. Surviving Sepsis Campaign Bundles Adherence and Their Limits in Surgical Patients with Septic Shock in an ICU. British Journal of Medicine and Medical Research. 2013 Jan-Mar; 3(1): 94-107.