scholarly journals Mortality rate reduction associated with a severe sepsis management protocol implementation

Critical Care ◽  
2007 ◽  
Vol 11 (S3) ◽  
Author(s):  
AG de Sousa ◽  
CJ Fernandes ◽  
G de Paula Dias Santos ◽  
E Silva ◽  
N Akamine ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Mortality Rate ◽  
Rate Reduction ◽  
Sepsis Management ◽  
Protocol Implementation ◽  
Management Protocol

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

scholarly journals Implementation strategy of a severe sepsis management protocol in a tertiary hospital

Critical Care ◽  
2007 ◽  
Vol 11 (S3) ◽  
Author(s):  
AG de Sousa ◽  
CJ Fernandes ◽  
G de Paula Dias Santos ◽  
E Silva ◽  
N Akamine ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Implementation Strategy ◽  
Tertiary Hospital ◽  
Sepsis Management ◽  
Management Protocol

Pre-Lung Transplant Waitlist Mortality Rate Reduction Using Remote Video Monitoring Technology

2019 ◽  
Vol 38 (4) ◽  
pp. S199
Author(s):  
M. Zubrinic ◽  
N. Marks ◽  
L. Brzozowski ◽  
J. Qiu ◽  
D. Lin ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Lung Transplant ◽  
Video Monitoring ◽  
Rate Reduction ◽  
Monitoring Technology ◽  
Waitlist Mortality

Implementation of a Standardized Perioperative Pain Management Protocol to Reduce Opioid Prescriptions in Otolaryngologic Surgery

2022 ◽  
pp. 019459982110711
Author(s):  
Michael T. Chang ◽  
M. Lauren Lalakea ◽  
Kimberly Shepard ◽  
Micah Saste ◽  
Amanda Munoz ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Lower Amount ◽  
Opioid Use ◽  
Protocol Implementation ◽  
Perioperative Pain ◽  
Management Protocol ◽  
Before And After ◽  
Perioperative Pain Management ◽  
Low Levels

Objective To evaluate the efficacy of implementing a standardized multimodal perioperative pain management protocol in reducing opioid prescriptions following otolaryngologic surgery. Study Design Retrospective cohort study. Setting County hospital otolaryngology practice. Methods A perioperative pain management protocol was implemented in adults undergoing otolaryngologic surgery. This protocol included preoperative patient education and a postoperative multimodal pain regimen stratified by pain level: mild, intermediate, and high. Opioid prescriptions were compared between patient cohorts before and after protocol implementation. Patients in the pain protocol were surveyed regarding pain levels and opioid use. Results We analyzed 210 patients (105 preprotocol and 105 postprotocol). Mean ± SD morphine milligram equivalents (MMEs) prescribed decreased from 132.5 ± 117.8 to 53.6 ± 63.9 ( P < .05) following protocol implementation. Mean MMEs prescribed significantly decreased ( P < .05) for each procedure pain tier: mild (107.4 to 40.5), intermediate (112.8 to 48.1), and high (240.4 to 105.0). Mean MMEs prescribed significantly decreased ( P < .05) for each procedure type: endocrine (105.6 to 44.4), facial plastics (225.0 to 50.0), general (160.9 to 105.7), head and neck oncology (138.6 to 77.1), laryngology (53.8 to 12.5), otology (77.5 to 42.9), rhinology (142.2 to 44.4), and trauma (288.0 to 24.5). Protocol patients reported a mean 1-week postoperative pain score of 3.4, used opioids for a mean 3.1 days, and used only 39% of their prescribed opioids. Conclusion Preoperative counseling and standardization of a multimodal perioperative pain regimen for otolaryngology procedures can effectively lower amount of opioid prescriptions while maintaining low levels of postoperative pain.

scholarly journals Differences in Hypotensive vs. Non-Hypotensive Sepsis Management in the Emergency Department: Door-to-Antibiotic Time Impact on Sepsis Survival

2018 ◽  
Vol 6 (4) ◽  
pp. 91
Author(s):  
Leonor Ballester ◽  
Rafael Martínez ◽  
Juan Méndez ◽  
Gloria Miró ◽  
Manel Solsona ◽  
...  
Keyword(s):  
Emergency Department ◽  
Severe Sepsis ◽  
Clinical Laboratory ◽  
University Hospital ◽  
Antibiotic Administration ◽  
Process Of Care ◽  
Sepsis Management ◽  
Initial Management ◽  
Sepsis Diagnosis ◽  
Community Onset

Background: Sepsis diagnosis can be incorrectly associated with the presence of hypotension during an infection, so the detection and management of non-hypotensive sepsis can be delayed. We aimed to evaluate how the presence or absence of hypotension, on admission at the emergency department, affects the initial management and outcomes of patients with community-onset severe sepsis. Methods: Demographic, clinical, laboratory, process of care, and outcome variables were recorded for all patients, at the emergency department of our university hospital, who presented with community-onset severe sepsis, between 1 March and 31 August in three consecutive years. Patient management consisted of standardized bundled care with five measures: Detection, blood cultures and empirical antibiotics, oxygen supplementation and fluid resuscitation (if needed), clinical monitoring, and noradrenalin administration (if needed). We compared all variables between patients who had hypotension (mean arterial pressure <65 mmHg), on admission to the emergency department, and those who did not. Results: We identified 153 episodes (84 (54.5%) men; mean age 73.6 ± 1.2; mean Sequential Organ Failure Assessment (SOFA) score 4.9 ± 2.7, and 41.2% hospital mortality). Hypotension was present on admission to the emergency department in 57 patients (37.2%). Hemodynamic treatment was applied earlier in patients who presented hypotension initially. Antibiotics were administered 48 min later in non-hypotensive sepsis (p = 0.08). A higher proportion of patients without initial hypotension required admission to the intensive care unit (ICU) (43.1% for patients initially hypotensive vs. 56.9% in those initially non-hypotensive, p < 0.05). Initial hypotension was not associated with mortality. A delay in door-to-antibiotic administration time was associated with mortality [OR 1.150, 95%CI: 1.043–1.268). Conclusions: Initial management of patients with community-onset severe sepsis differed according to their clinical presentation. Initial hypotension was associated with early hemodynamic management and less ICU requirement. A non-significant delay was observed in the administration of antibiotics to initially non-hypotensive patients. The time of door-to-antibiotic administration was related to mortality.

A new approach to train intensive care specialists using a full-scale anaesthesia simulator in severe sepsis management

2004 ◽  
Vol 21 (Supplement 32) ◽  
pp. 207
Author(s):  
G. H. Breuer ◽  
R. Riss ◽  
M. Cobas-Meyer ◽  
F. Bremer ◽  
M. Grapengeter ◽  
...  
Keyword(s):  
Severe Sepsis ◽  
Intensive Care ◽  
Full Scale ◽  
Sepsis Management ◽  
New Approach

Sepsis

2020 ◽  
Author(s):  
Steven P LaRosa ◽  
Steven M. Opal
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Organ Dysfunction ◽  
Fluid Resuscitation ◽  
Multiorgan Failure ◽  
Sepsis Management ◽  
The Past ◽  
Sepsis And Septic Shock

Sepsis, along with the multiorgan failure that often accompanies this condition, is a leading cause of mortality in the intensive care unit. Although modest improvements in the prognosis have been made over the past two decades and promising new therapies continue to be investigated, innovations in the management of septic shock are still required. This chapter discusses the definitions, epidemiology, and pathogenesis (including microbial factors, host-derived mediators, and organ dysfunction) relating to sepsis. Management of severe sepsis and septic shock is also described.  This review contains 5 figures, 11 tables, and 99 references. Keywords:Organ dysfunction, sepsis, septic shock, infection, bacteremia, fluid resuscitation, vasopressor

Temporal trend and survival impact of infection source among patients with sepsis: a nationwide study

2020 ◽  
Vol 22 (2) ◽  
pp. 126-132
Author(s):  
Yueh-Sheng Chen ◽  
◽  
Tin-Yun Liao ◽  
Tzu-Chun Hsu ◽  
Wan-Ting Hsu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Lower Respiratory Tract ◽  
Temporal Trends ◽  
Administrative Database ◽  
Common Source ◽  
Sepsis Management ◽  
Incidence And Mortality ◽  
Different Sources

BACKGROUND: To determine the temporal trends of incidence and outcome based on different sources of sepsis using a nationwide administrative database. METHODS: From 2002 to 2012, the entire Taiwan's health insurance claims data of emergency-treated and hospital-treated sepsis were analysed for incidence and mortality trends. The information about patients with sepsis and sources of sepsis was identified using a set of validated International Classification of Diseases, ninth revision, clinical modification (ICD-9-CM) codes. The 30-day all-cause mortality was verified by linked death certificate database. RESULTS: A total of 1 259 578 episodes of sepsis were identified during the 11-year study period. Lower respiratory tract infection is the most common source of sepsis in patients, with the highest mortality rate. The incidence of genitourinary tract infection has the fastest growing rate. The sepsis mortality was declining at different rates for each source of sepsis. Co-infections in patients with sepsis are associated with higher mortality rate. CONCLUSION: The temporal trends of sepsis incidence and mortality varied among different sources of sepsis, with lower respiratory tract being the highest burden among patients with sepsis. Furthermore, sources of sepsis and the presence of co-infection are independent predictors of mortality. Our results support source-specific preventive and treatment strategies for future sepsis management.

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