Compliance of sepsis hour-1 bundle strategy for patients with septic shock in emergency department
10.3760/cma.j.cn114798-20211021-00786
- VernacularTitle:急诊脓毒性休克患者1 h集束化治疗策略临床实施依从性的观察
- Author:
Liang XU
1
;
Zhiwei GAO
;
Weiqin WU
;
Yadong YU
;
Weijun GUO
;
Qi LI
;
Changming ZHAO
;
Yujun CHEN
;
Siwei WANG
;
Hongmei ZHAO
;
Hong SUN
;
Jinsong ZHANG
Author Information
1. 南京医科大学附属淮安第一医院急诊医学科，淮安 223300
- Keywords:
Shock,septic;
Sepsis hour-1 bundle strategy;
Emergency medical services;
Adherence
- From:
Chinese Journal of General Practitioners
2022;21(1):42-47
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the implementation status of sepsis hour-1 bundle strategy for patients with septic shock in emergency department.Methods:A total of 116 septic shock patients admitted to the emergency department from January 2020 to December 2020 were included in this prospective study, and the implementation of sepsis bundles and the clinical outcomes of patients were recorded.Results:Among 116 patients, 20 cases (17.2%) had lactic acid monitored within 1 h, 20 cases (17.2%) had blood culture before antibiotics, 82 cases (70.1%) received broad-spectrum antibiotics, 16 cases (13.8%) received fluid resuscitation ≥30 ml/kg, and 57 cases (49.1%) received vasoactive drugs during resuscitation. Finally, the sepsis hour-1 bundle strategy was fully implemented only in 13 cases (11.2%). Compared with the group with incomplete implementation of sepsis hour-1 bundle strategy, the volume of fluid recovery in the group with full implementation was significantly increased [33.7 (30.0,37.5) vs. 8.9(7.3,10.8) ml/kg, Z=-4.78, P<0.001], mean artery blood pressure significantly increased [70.0 (70.0,76.7) vs. 67.7 (61.7,76.7)mmHg(1 mmHg=0.133 kPa) , Z=-2.00, P<0.001], and lactic acid significantly decreased [3.0 (2.0,3.2) vs. 4.4 (3.7,7.2) mmol/L, Z=-2.76, P=0.006]. However, there were no significant differences in ICU mortality, in-hospital mortality and 28-day mortality between the two groups ( P>0.05). Conclusions:Septic shock patients in emergency department have poor compliance with the implementation of sepsis hour-1 bundle strategy, and relevant management training should be strengthened.
