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- W2316306523 abstract "Introduction: Resuscitation bundles (RB) from the Surviving Sepsis Campaign (SSC) guidelines with rapid recognition and aggressive intervention of septic shock (SS) dramatically improves outcome. Recent studies suggest that hospitals are less than 25% compliant with the suggested treatment guidelines. We examined the impact of the RB on outcomes of SS patients when completed beyond the 6-hour recommendation period. Methods: This study was completed at a large university-affiliated hospital evaluating patients with SS between July 2011 and January 2013. Data elements were prospectively collected. Compliance with the hemodynamic components of the RB was defined as achieving goal mean arterial pressure (MAP) >65 mm Hg, central venous pressure (CVP) > 8 mm Hg, and central venous oxygen saturation (ScvO2) > 70%, lactic acid measurement, and appropriate antibiotics prescribed within 3 hours. Compliance was assessed at 6 hours and 18 hours after diagnosis of SS. Septic shock patients were divided into three groups: RB compliance at 6 hours (C 6, n = 95, 24 % compliance), RB compliance between 6 and 18 hours (C 18, n = 85), and RB noncompliance at 18 hours (NC, n = 215). Primary outcome was hospital mortality. Results: The 3 groups were similar regarding the following: age in years, 67 (+/- 16) vs 67 (+/- 17) vs 68 (+/-16) (p = 0.9); weight in Kgs, 82 (+/- 28) vs 80 (+/- 23) vs 79 (+/- 28) (p=0.7); and sequential organ failure assessment (SOFA) scores, 8 (+/- 4) vs 7 (+/-3) vs 8 (+/- 4) (p=0.06) in the C6 vs C 18 vs NC groups respectively. Using Cox proportional hazard analysis and adjusting for differences in severity of illness and baseline characteristics, both C6 (hazard ration [HR] = 0.45; 95 % CI, 0.24 – 0.85, p = 0.01) and C18 (HR = 0.12; 95 % CI, 0.04 – 0.39, p < 0.001) had a reduction in mortality compared to the NC group. Conclusions: Multiple studies have shown that compliance with the RB within 6 hours lowers hospital mortality. This study demonstrates that RB compliance extended up to 18 hours confers a significant mortality reduction in patients diagnosed with septic shock." @default.
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- W2316306523 date "2013-12-01" @default.
- W2316306523 modified "2023-10-09" @default.
- W2316306523 title "57" @default.
- W2316306523 doi "https://doi.org/10.1097/01.ccm.0000439241.94724.42" @default.
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