Reducing mortality in severe sepsis with the implementation of a core 6-hour bundle: results from the Portuguese community-acquired sepsis study (SACiUCI study)

• DOI: 10.1186/cc9008
• Publication Date: 2010-06-16T20:32:45Z
• Authors: Teresa Cardoso; António Henriques...; Orquídea Ribeiro; Armando Teixeira-...; Altamiro Costa-Pe...
• Keywords: Surviving Sepsis Campaign; Dobutamine; Blood Culture

To evaluate the impact of compliance with a core version Surviving Sepsis Campaign 6-hour bundle on 28 days mortality.Cohort, multi-centre, prospective study community-acquired sepsis (CAS).Seventeen intensive care units (ICU) entered study. Over one year period, 4,142 patients were enrolled in Of 897 (24%) admitted CAS, 778 (87%) had severe or septic shock ICU admission. In first six hours hospital admission: (1) 62% serum lactate measured; (2) 69% fluids administered; (3) 77% specimens collected for microbiology before antibiotic administration; (4) 48% blood cultures obtained; (5) 52% antibiotics administered within hour diagnosis; (6) vasopressors given 78%; (7) 56% central venous measurement (CVP) measurement; (8) 17% oxygen saturation (ScvO2) (9) dobutamine was 52%. Compliance all actions 1 to 6 (core bundle) associated an odds ratio (OR) 0.44 [95% confidence interval (CI) = 0.24-0.80] and 0.49 (95% CI 0.25-0.95) shock, mortality. This corresponded number needed treat save life.Compliance this significant reduction Urgent action should be taken order ensure that early diagnosis is followed by full completion "core bundle" activation expertise help sepsis.