Septic Shock

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Severe sepsis and septic shock represents a significant healthcare problem among hospitalized patients. It is a major cause of mortality especially among older patients and patients with multiple pathologies, many of whom are admitted through emergency departments (EDs) (Coen et al., 2014). The research suggests that while not all patients with septic shock is admitted through the ED, the care received by patients in the ED may significantly impact their prognosis (Coen e.t al., 2014). EGDT has been incorporated into EDs to treat patients with severe sepsis or septic shock in the form of Surviving Sepsis Campaign (SSC). EGDT involves following a well-defined algorithm during the first 6 hours of treatment that includes administering
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The study was carried out at a suburban community hospital over a 31-month period. All patients with SS/SS between July 2007 and January 2010 who were admitted to the community hospital were included in the study. Postsurgical patients were not included in the study. A total of 267 patients (155 EDIs and 112 NEDIs). The primary outcome measure was difference in mortality rates of SS/SS EDI patients and SS/SS NEDI patients. Length of stay (LoS), direct costs (DC) and final disposition data for both groups of participants were used as secondary outcome measures. The SSC guidelines was first implemented in 2005 by forming a multidisciplinary team of nurses, physicians, pharmacists and Critical Care and Emergency Medicine administrative staff members. Team members educated, staffs and physicians about the SSC guidelines. They tracked the extent to which SSC measures blood culture collection, crystalloid resuscitation, use of vasopressors/blood pressure products, administration of early broad-spectrum antibiotic/recombinant human-activated protein C, and initiations of tight glycemic control were achieved. Three research associates who were…show more content…
A total of 60 patients, mean age of 66.3 years and 86.7% male admitted to the ED and who received resuscitation using the standard EGDT algorithm for severe sepsis and septic shock and who were treated with CRRT because of septic AKI. The study conducted from June 2008 to February 2013 at a tertiary hospital in Seoul, Korea. The participants were assigned to two groups; on the basis of the median between the time they started the EGDT and the CRRT. The main outcomes measure the cause of 28-day mortality. The 28-day mortality rate was 43.3%. The overall cause of mortality rate was significantly higher for the late CRRT groups, than the early CRRT group 56.7 versus. 30.0%. The authors conclude that initiating CRRT early may be beneficial to improving mortality rate among patients with severe sepsis or septic shock, but indicate that more clinical trials are needed to accurately determine whether early CCRT is more efficacious than late CRRT in the treatment of septic
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