Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives

Abstract

Purpose Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. Materials and methods Retrospective review of patients ≥18 years treated for sepsis. Results There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p = 0.94) and Charlson Comorbidity Scores (2.52 vs. 2.47, p = 0.35) were similar between groups. Multivariable analyses identified significant reductions in the after phase for odds of death (OR 0.62, 95% CI 0.39–0.99, p = 0.046), mean intensive care unit LOS (2.12 days before, 95%CI 1.97, 2.34; 1.95 days after, 95%CI 1.75, 2.06; p < 0.001), mean overall hospital LOS (11.7 days before, 95% CI 10.9, 12.7 days; 9.9 days after, 95% CI 9.3, 10.6 days, p < 0.001), odds of mechanical ventilation use (OR 0.62, 95% CI 0.39, 0.99, p = 0.007), and total charges with a savings of $7159 per sepsis admission (p = 0.036). There was no reduction in vasopressor use (OR 0.89, 95% CI 0.75, 0.1.06, p = 0.18). Conclusion A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.

LIPid Intensive Drug therapy for Sepsis Pilot (LIPIDS-P): Phase I/II clinical trial protocol of lipid emulsion therapy for stabilising cholesterol levels in sepsis and septic shock

“…Thus, the phase II arm will include 24 patients randomised to one of the two doses of the study drug, while the control group will consist of 24 patients who receive no drug but are followed while in-hospital (active controls) (figure 1). The control group will receive standard treatments guided by the institutional sepsis alert protocol 37. For purposes of statistical outcomes analysis, the control group will be the comparison group.…”

Terminal sterilization of medical devices using vaporized hydrogen peroxide: a review of current methods and emerging opportunities

“…Infections acquired in hospital may lead to sepsis, a ‘life threatening organ dysfunction caused by a dysregulated host response to infection’ (Dugani et al ; Masterson et al ). There are some 750 000 cases of sepsis annually in the United States, with a cost to healthcare of c. $20bn (Guirgis et al ). While there are many known sources of HAIs (Bauld ; Dasenbrock et al ), terminally sterilized medical devices are unlikely to be a point source of infection due to associated rigorous sterilization and validation processes that deliver a sterility assurance level (SAL) far above the minimum requirements to achieve sterilization for patient safety.…”

Resuscitation Resident Impact in the Treatment of Sepsis

“…Studies have demonstrated a BPA leading to decreased time to antibiotics and other parameters [14][15], nevertheless, it did not lead to an improvement in mortality [14][15]. Personnel driven models, either with a sepsis response team or triage protocol, have also had varying degrees of success with decreasing time to sepsis bundle parameters [7][8][9][10][11], with only one demonstrating a possible mortality benefit [16]. Overall, similar to our study, the vast majority of these interventions have led to some improvement in achieving different sepsis core measurements [7][8][9][10][11][13][14][15][16][17].…”