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Implementing surviving sepsis campaign bundles in China: a prospective cohort study

摘要Background Surviving sepsis campaign (SSC) bundles have been demonstrated to significantly improve survival in sepsis and septic shock patients worldwide.Compliance with these protocols and resultant mortality in sepsis patients was investigated in intensive care units (ICUs) in China.Methods Adult patients with severe sepsis or septic shock treated from September 2007 to October 2008 in 11 ICUs of Chinese teaching hospitals were included.The primary outcome was compliance with resuscitation and management bundles.Secondary outcomes included individual bundle protocol impact and the effects of the completed bundle protocol number on 28-day mortality.Results Overall compliance during 6-hr resuscitation and 24-hour management bundles were 5.5% and 17.4%,respectively,and 28-day mortality was 33.0%.Compliance with protocols for blood cultures before antibiotics (42.2%),central venous pressure ≥8 mmHg (65.9%),central venous oxygen saturation ≥70% (25.0%),and optimized glucose control (82.1%),were significantly associated with decreased 28-day mortality (P <0.05).When adjusted for age,acute organ dysfunction,and APACHE Ⅱ score,compliance with the blood culture before antibiotics protocol produced the most significant decrease in 28-day mortality (OR,0.33; 95% Cl,0.16-0.70; P=-0.004).Compliance with ≥5 protocols in the 6-hour resuscitation bundle was also associated with lower 28-day mortality in septic shock patients (OR,0.17; 95% Cl,0.06-0.54; P =0.001).Conclusions Compliance with resuscitation and management bundles is generally poor in China; however,when applied,6-hour resuscitation bundle are associated with significant reductions in 28-day mortality for sepsis patients.

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作者单位 Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing 100038, China [1]
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DOI 10.3760/cma.j.issn.0366-6999.20122744
发布时间 2013-07-05(万方平台首次上网日期,不代表论文的发表时间)
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中华医学杂志(英文版)

中华医学杂志(英文版)

2013年126卷10期

1819-1825页

SCIMEDLINEISTICCSCDCABP

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