scholarly journals Saving 500 Lives Campaign: another way to improve the mortality rate of patients with severe sepsis and septic shock

Critical Care ◽  
2012 ◽  
Vol 16 (S3) ◽  
Author(s):  
R Champunot ◽  
N Kamsawang ◽  
P Tuandoung ◽  
S Tansuphaswasdikul
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Mortality Rate ◽  
Sepsis And Septic Shock

scholarly journals The Hypotension Period after Initiation of Appropriate Antimicrobial Administration Is Crucial for Survival of Bacteremia Patients Initially Experiencing Severe Sepsis and Septic Shock

2020 ◽  
Vol 9 (8) ◽  
pp. 2617
Author(s):  
Ching-Chi Lee ◽  
Chao-Yung Yang ◽  
Bo-An Su ◽  
Chih-Chia Hsieh ◽  
Ming-Yuan Hong ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Mortality Rate ◽  
Positive Trend ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Sepsis And Septic Shock ◽  
Community Onset ◽  
Substantial Morbidity ◽  
Antimicrobial Administration

Bacteremia is linked to substantial morbidity and medical costs. However, the association between the timing of achieving hemodynamic stability and clinical outcomes remains undetermined. Of the multicenter cohort consisted of 888 adults with community-onset bacteremia initially complicated with severe sepsis and septic shock in the emergency department (ED), a positive linear-by-linear association (γ = 0.839, p < 0.001) of the time-to-appropriate antibiotic (TtAa) and the hypotension period after appropriate antimicrobial therapy (AAT) was exhibited, and a positive trend of the hypotension period after AAT administration in the 15-day (γ = 0.957, p = 0.003) or 30-day crude (γ = 0.975, p = 0.001) mortality rate was evidenced. Moreover, for every hour delay of the TtAa, 30-day survival dropped an average of 0.8% (adjusted odds ratio [AOR], 1.008; p < 0.001); and each additional hour of the hypotension period following AAT initiation notably resulted in with an average 1.1% increase (AOR, 1.011; p < 0.001) in the 30-day crude mortality rate, after adjusting all independent determinants of 30-day mortality recognized by the multivariate regression model. Conclusively, for bacteremia patients initially experiencing severe sepsis and septic shock, prompt AAT administration might shorten the hypotension period to achieve favourable prognoses.

scholarly journals Mortality rate reduction associated with severe sepsis and septic shock management protocol implementation

Critical Care ◽  
2007 ◽  
Vol 11 (S4) ◽  
Author(s):  
Constantino José Fernandes ◽  
Alexandre Gonçalves de Sousa ◽  
Gisele de Paula Dias Santos ◽  
Eliezer Silva ◽  
Nelson Akamine
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Mortality Rate ◽  
Rate Reduction ◽  
Protocol Implementation ◽  
Management Protocol ◽  
Sepsis And Septic Shock

Effect of fluid bolus triggers and their combination on fluid responsiveness in optimization phase of severe sepsis and septic shock resuscitation

MedPharmRes ◽  
2018 ◽  
Vol 2 (3) ◽  
pp. 27-32
Author(s):  
Bien Le ◽  
Dai Huynh ◽  
Mai Tuan ◽  
Minh Phan ◽  
Thao Pham ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Fluid Responsiveness ◽  
Statistical Significance ◽  
Venous Pressure ◽  
Fluid Bolus ◽  
Low Blood Pressure ◽  
Low Central Venous Pressure ◽  
Sepsis And Septic Shock

Objectives: to evaluate the fluid responsiveness according to fluid bolus triggers and their combination in severe sepsis and septic shock. Design: observational study. Patients and Methods: patients with severe sepsis and septic shock who already received fluid after rescue phase of resuscitation. Fluid bolus (FB) was prescribed upon perceived hypovolemic manifestations: low central venous pressure (CVP), low blood pressure, tachycardia, low urine output (UOP), hyperlactatemia. FB was performed by Ringer lactate 500 ml/30 min and responsiveness was defined by increasing in stroke volume (SV) ≥15%. Results: 84 patients were enrolled, among them 30 responded to FB (35.7%). Demographic and hemodynamic profile before fluid bolus were similar between responders and non-responders, except CVP was lower in responders (7.3 ± 3.4 mmHg vs 9.2 ± 3.6 mmHg) (p 0.018). Fluid response in low CVP, low blood pressure, tachycardia, low UOP, hyperlactatemia were 48.6%, 47.4%, 38.5%, 37.0%, 36.8% making the odd ratio (OR) of these triggers were 2.81 (1.09-7.27), 1.60 (0.54-4.78), 1.89 (0.58-6.18), 1.15 (0.41-3.27) and 1.27 (0.46-3.53) respectively. Although CVP < 8 mmHg had a higher response rate, the association was not consistent at lower cut-offs. The combination of these triggers appeared to raise fluid response but did not reach statistical significance: 26.7% (1 trigger), 31.0% (2 triggers), 35.7% (3 triggers), 55.6% (4 triggers), 100% (5 triggers). Conclusions: fluid responsiveness was low in optimization phase of resuscitation. No fluid bolus trigger was superior to the others in term of providing a higher responsiveness, their combination did not improve fluid responsiveness as well.

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