T Grendel1, V Hudák, J Firment. 1. I. klinika anestéziológie a intenzívnej medicíny, Lekárska fakulta Univerzity Pavla Jozefa Safárika, Kosice, Slovenská republika.
Abstract
INTRODUCTION: Severe sepsis is currently reported the commonest cause of deaths in non-surgical emergency department patients. The aim of the study was to establish degree of complicance with diagnostic and therapeutic procedures in the severe sepsis treatment, as a part of the "Surviving sepsis campaign". Furthermore, the authors aimed to assess success rates of corticosteroid administration, its effects on circulatory stabilization and to assess the healthcare professionals' awareness of the campaign. METHODOLOGY: The patients were assigned to three study groups (n = 103). The following parametres were assessed: complicance with the "resuscitation and management package", death rate and hydrocortisone administration. An anonymous questionnaire for the medical specialists in individual FNLP Kosice clinics was created. RESULTS: In the assessed group, the death rate decreased by 15.61% (p < 0.05) in 2006, compared to 2004. Administration of corticosteroids increased by 49.2% in 2006, compared to 2004, while the time interval between the onset of the septic shock symptoms and the catecholamine administration decreased significantly. CONCLUSION: Considering the reduction in the time interval between the onset of the septic shock symptoms and the catecholamine administration, and considering its established positive effects on circulation, it may be concluded that administration of low-dose hydrocortisone in the septic shock treatment is substantiated.
INTRODUCTION: Severe sepsis is currently reported the commonest cause of deaths in non-surgical emergency department patients. The aim of the study was to establish degree of complicance with diagnostic and therapeutic procedures in the severe sepsis treatment, as a part of the "Surviving sepsis campaign". Furthermore, the authors aimed to assess success rates of corticosteroid administration, its effects on circulatory stabilization and to assess the healthcare professionals' awareness of the campaign. METHODOLOGY: The patients were assigned to three study groups (n = 103). The following parametres were assessed: complicance with the "resuscitation and management package", death rate and hydrocortisone administration. An anonymous questionnaire for the medical specialists in individual FNLP Kosice clinics was created. RESULTS: In the assessed group, the death rate decreased by 15.61% (p < 0.05) in 2006, compared to 2004. Administration of corticosteroids increased by 49.2% in 2006, compared to 2004, while the time interval between the onset of the septic shock symptoms and the catecholamine administration decreased significantly. CONCLUSION: Considering the reduction in the time interval between the onset of the septic shock symptoms and the catecholamine administration, and considering its established positive effects on circulation, it may be concluded that administration of low-dose hydrocortisone in the septic shock treatment is substantiated.
Authors: Richard Beale; Jonathan M Janes; Frank M Brunkhorst; Geoffrey Dobb; Mitchell M Levy; Greg S Martin; Graham Ramsay; Eliezer Silva; Charles L Sprung; Benoit Vallet; Jean-Louis Vincent; Timothy M Costigan; Amy G Leishman; Mark D Williams; Konrad Reinhart Journal: Crit Care Date: 2010-06-03 Impact factor: 9.097