Outcome of delayed resuscitation bundle achievement in emergency department patients with septic shock

2014 ◽  
Vol 9 (6) ◽  
pp. 671-676 ◽  
Author(s):  
Chang Hwan Sohn ◽  
Seung Mok Ryoo ◽  
Dong Woo Seo ◽  
Jae Ho Lee ◽  
Bum Jin Oh ◽  
...  
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Emergency Department Patients ◽  
Resuscitation Bundle

Sepsis

2019 ◽  
Author(s):  
Michael R. Filbin
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Lactate Production ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Lengths Of Stay ◽  
Organ Failures ◽  
Hospital Deaths ◽  
Time To Antibiotics ◽  
Emergency Department Patients

Sepsis accounts for approximately one in three hospital deaths, and is associated with very high health care costs due to prolonged lengths of stay in the intensive care unit and hospital. Sepsis is essentially an immunologic response to infection that is propagated systemically, leading to diffuse cellular and microcirculatory dysfunction, vasodilation, vital organ hypoperfusion, and eventual failure. This review covers the pathophysiology, stabilization/assessment, diagnosis, treatment, and disposition and outcomes of sepsis. Figures show the inflammatory and thrombotic response to infection, the action of nitric oxide on vascular smooth muscle cells, accelerated glycolysis and increased lactate production as a result of the catecholamine surge seen in septic shock, sepsis mortality associated with number of organ failures identified in the emergency department (ED), and protocolized therapy for septic shock. Tables list definitions of sepsis syndromes; frequently cited scoring systems for mortality prediction in emergency department patients with sepsis; Sequential Organ Failure Assessment (SOFA) score; current recommendations regarding treatment bundles at 3 and 6 hours of resuscitation; antibiotic recommendations based on suspected source; and vasopressors used in septic shock with recommended dosing, mechanism of action, and indications. This review contains 5 figures, 7 tables, and 57 references. Keywords: Sepsis; Surviving Sepsis Campaign guidelines, definitions, SEP-1 sepsis quality measure, time-to-antibiotics, volume resuscitation, lactated ringers

Sepsis

2018 ◽  
Author(s):  
Michael R. Filbin
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Lactate Production ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Lengths Of Stay ◽  
Organ Failures ◽  
Hospital Deaths ◽  
Time To Antibiotics ◽  
Emergency Department Patients

Sepsis accounts for approximately one in three hospital deaths, and is associated with very high health care costs due to prolonged lengths of stay in the intensive care unit and hospital. Sepsis is essentially an immunologic response to infection that is propagated systemically, leading to diffuse cellular and microcirculatory dysfunction, vasodilation, vital organ hypoperfusion, and eventual failure. This review covers the pathophysiology, stabilization/assessment, diagnosis, treatment, and disposition and outcomes of sepsis. Figures show the inflammatory and thrombotic response to infection, the action of nitric oxide on vascular smooth muscle cells, accelerated glycolysis and increased lactate production as a result of the catecholamine surge seen in septic shock, sepsis mortality associated with number of organ failures identified in the emergency department (ED), and protocolized therapy for septic shock. Tables list definitions of sepsis syndromes; frequently cited scoring systems for mortality prediction in emergency department patients with sepsis; Sequential Organ Failure Assessment (SOFA) score; current recommendations regarding treatment bundles at 3 and 6 hours of resuscitation; antibiotic recommendations based on suspected source; and vasopressors used in septic shock with recommended dosing, mechanism of action, and indications. This review contains 5 figures, 7 tables, and 57 references. Keywords: Sepsis; Surviving Sepsis Campaign guidelines, definitions, SEP-1 sepsis quality measure, time-to-antibiotics, volume resuscitation, lactated ringers  

scholarly journals Comparison Between Culture-Positive and Culture-Negative Septic Shock in Emergency Department Patients

2022 ◽  
Author(s):  
Yen-Chang Huang ◽  
Chi-Chieh Hung ◽  
Yong-Ye Yang ◽  
Tsung-Han Wang ◽  
Yin-Chou Hsu
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Clinical Characteristics ◽  
Management Strategies ◽  
Intensive Care Unit Care ◽  
Antibiotic Administration ◽  
Retrospective Case ◽  
Emergency Department Patients ◽  
Culture Positive ◽  
Culture Negative

Abstract Culture results in patients with septic shock affect their management strategies. Our study aimed to compare the clinical characteristics and outcomes of patients with culture-negative septic shock (CNSS) and culture-positive septic shock (CPSS). A single-center, retrospective, case-control study included adult patients diagnosed with septic shock in the emergency department between January 1, 2019 and March 31, 2020. They were divided into CNSS and CPSS groups based on their culture results. Patients with CPSS (63.7%, 311/488) and CNSS (36.3%, 177/488) were identified. The CPSS and CNSS groups had comparable clinical outcomes, including mechanical ventilation (29.6% vs. 32.8%, p = 0.46), renal replacement therapy (19.3% vs. 23.2%, p = 0.31), intensive care unit care (51.8% vs. 45.2%, p = 0.16), 30-day (35.7% vs. 36.7%, p = 0.82) and in-hospital mortality (39.5% vs. 41.8%, p = 0.63). The duration (13 [8−19] vs. 16 [10−23], days, p = 0.04) and de-escalation timing (5 [2−10] vs. 9 [7−12], day, p = 0.02) of antibiotic administration in the CNSS group was significantly shorter and earlier than in the CPSS group. Patients with CNSS and CPSS had similar clinical characteristics and adverse outcome proportions. Physicians can evaluate the feasibility of early de-escalation or discontinuation of antibiotic administration in CNSS patients with clinical improvement.

Sepsis

2019 ◽  
Author(s):  
Michael R. Filbin
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Lactate Production ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Lengths Of Stay ◽  
Organ Failures ◽  
Hospital Deaths ◽  
Time To Antibiotics ◽  
Emergency Department Patients

Sepsis accounts for approximately one in three hospital deaths, and is associated with very high health care costs due to prolonged lengths of stay in the intensive care unit and hospital. Sepsis is essentially an immunologic response to infection that is propagated systemically, leading to diffuse cellular and microcirculatory dysfunction, vasodilation, vital organ hypoperfusion, and eventual failure. This review covers the pathophysiology, stabilization/assessment, diagnosis, treatment, and disposition and outcomes of sepsis. Figures show the inflammatory and thrombotic response to infection, the action of nitric oxide on vascular smooth muscle cells, accelerated glycolysis and increased lactate production as a result of the catecholamine surge seen in septic shock, sepsis mortality associated with number of organ failures identified in the emergency department (ED), and protocolized therapy for septic shock. Tables list definitions of sepsis syndromes; frequently cited scoring systems for mortality prediction in emergency department patients with sepsis; Sequential Organ Failure Assessment (SOFA) score; current recommendations regarding treatment bundles at 3 and 6 hours of resuscitation; antibiotic recommendations based on suspected source; and vasopressors used in septic shock with recommended dosing, mechanism of action, and indications. This review contains 5 figures, 7 tables, and 57 references. Keywords: Sepsis; Surviving Sepsis Campaign guidelines, definitions, SEP-1 sepsis quality measure, time-to-antibiotics, volume resuscitation, lactated ringers

Sepsis

2019 ◽  
Author(s):  
Michael R. Filbin
Keyword(s):  
Emergency Department ◽  
Septic Shock ◽  
Lactate Production ◽  
Scoring Systems ◽  
Mortality Prediction ◽  
Lengths Of Stay ◽  
Organ Failures ◽  
Hospital Deaths ◽  
Time To Antibiotics ◽  
Emergency Department Patients

Sepsis accounts for approximately one in three hospital deaths, and is associated with very high health care costs due to prolonged lengths of stay in the intensive care unit and hospital. Sepsis is essentially an immunologic response to infection that is propagated systemically, leading to diffuse cellular and microcirculatory dysfunction, vasodilation, vital organ hypoperfusion, and eventual failure. This review covers the pathophysiology, stabilization/assessment, diagnosis, treatment, and disposition and outcomes of sepsis. Figures show the inflammatory and thrombotic response to infection, the action of nitric oxide on vascular smooth muscle cells, accelerated glycolysis and increased lactate production as a result of the catecholamine surge seen in septic shock, sepsis mortality associated with number of organ failures identified in the emergency department (ED), and protocolized therapy for septic shock. Tables list definitions of sepsis syndromes; frequently cited scoring systems for mortality prediction in emergency department patients with sepsis; Sequential Organ Failure Assessment (SOFA) score; current recommendations regarding treatment bundles at 3 and 6 hours of resuscitation; antibiotic recommendations based on suspected source; and vasopressors used in septic shock with recommended dosing, mechanism of action, and indications. This review contains 5 figures, 7 tables, and 57 references. Keywords: Sepsis; Surviving Sepsis Campaign guidelines, definitions, SEP-1 sepsis quality measure, time-to-antibiotics, volume resuscitation, lactated ringers

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