Quality Improvement Initiative for Severe Sepsis and Septic Shock Reduces 90-Day Mortality: A 7.5-Year Observational Study*

Critical Care Medicine 45(2), February 2017, p 241–252

This study investigates the impact of a quality improvement initiative for severe sepsis and septic shock focused on the resuscitation bundle on 90-day mortality. Furthermore, effects on compliance rates for antiinfective therapy within the recommended 1-hour interval are evaluated. The article concludes, that the continuous quality improvement initiative focused on the resuscitation bundle was associated with increased compliance and a persistent reduction in 90-day mortality over a 7.5-year period. Based on the observational study design, a causal relationship cannot be proven, and respective limitations need to be considered.

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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Critical Care Medicine Volume 45(3), March 2017, p 486–552

A consensus committee of 55 international experts representing 25 international organisations was convened to provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012.”

The panel provided 93 statements on early management and resuscitation of patients with sepsis or septic shock. Overall, 32 were strong recommendations, 39 were weak recommendations, and 18 were best-practice statements. No recommendation was provided for four questions. In conclusion, substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.

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Sepsis and Septic Shock: Current Treatment Strategies and New Approaches

The Eurasian Journal of Medicine. 2017 Feb;49(1):53-58

Many studies have been conducted on sepsis that cause shock, multiorgan dysfunction, and organ failure by especially leading to hemodynamic changes. In sepsis, increasing antibiotic resistance and medicine-resistant hemodynamic changes have resulted in further research on new treatment modalities in addition to classical treatments. In the last decade, the sepsis physiopathology has been elucidated. Various therapeutic agents have been used in addition to antibiotherapy, but no satisfactory results have been obtained. This review summarizes the sepsis pathophysiology, current treatment protocols, and new approaches.

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Protocol Adherence for Severe Sepsis and Septic Shock Management in the Emergency Department; a Clinical Audit.

Emergency. 2017; 5 (1): e16

This study was aimed to audit the management of severe sepsis and septic shock patients in emergency department (ED) according to the present standard guidelines.  This is a prospective audit on approaching adult septic patients who were admitted to ED. The audit checklist was created based on the protocols of Surviving Sepsis Campaign and British Royal College recommendations.

The article concludes that protocol adherence in management of severe sepsis and septic shock for urine output measurement, central venous pressure monitoring, administration of inotrope agents, blood transfusion, intravenous antibiotic and hydration therapy, and high flow O2 delivery were disappointingly low. It seems training workshops and implementation of Clinical audit can improve residents’ adherence to current standard guidelines regarding severe sepsis and septic shock

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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Intensive Care Med. 2017 Jan 18. doi: 10.1007/s00134-017-4683-6. [Epub ahead of print]

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A consensus committee of 55 international experts representing 25 international organizations was convened to provide an update to “Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012. The panel consisted of five sections: hemodynamics, infection, adjunctive therapies, metabolic, and ventilation. Each subgroup generated a list of questions, searched for best available evidence, and then followed the principles of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the quality of evidence from high to very low, and to formulate recommendations as strong or weak, or best practice statement when applicable. In conclusion, substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.