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拯救脓毒症运动脓毒症改变集束与临床实践。

The Surviving Sepsis Campaign sepsis change bundles and clinical practice.

作者信息

Dellinger R Phillip, Vincent Jean-Louis

机构信息

Section of Critical Care Medicine, Cooper University Hospital, Robert Wood Johnson Medical School, Camden, New Jersey, USA.

出版信息

Crit Care. 2005;9(6):653-4. doi: 10.1186/cc3952. Epub 2005 Nov 25.

DOI:10.1186/cc3952
PMID:16356261
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1414046/
Abstract

The Surviving Sepsis Campaign (SSC) is an international effort to reduce mortality in severe sepsis and septic shock. The campaign included the creation of evidence-based guidelines sponsored and endorsed by 11 international organizations. From these guidelines, sepsis change bundles for initial resuscitation (6 hours) and management (24 hours) were created as a performance improvement tool. In this issue of Critical Care, Gao et al. have evaluated performance at their institution by using a close adaptation of the two SSC bundle sets and demonstrated an association between 100% compliance with the bundle elements and clinical outcome. The next step will be to demonstrate that the use of education and feedback for performance improvement will increase compliance and decrease mortality in the patient population in general.

摘要

拯救脓毒症运动(SSC)是一项旨在降低严重脓毒症和脓毒性休克死亡率的国际行动。该运动包括制定由11个国际组织发起和认可的循证指南。基于这些指南,制定了用于初始复苏(6小时)和管理(24小时)的脓毒症改进集束方案,作为一种绩效改进工具。在本期《重症监护》中,高等人通过紧密采用两套SSC集束方案评估了他们机构的绩效,并证明了100%符合集束要素与临床结果之间的关联。下一步将是证明利用教育和反馈来改进绩效将提高总体患者群体的依从性并降低死亡率。

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本文引用的文献

1
The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study.6小时和24小时脓毒症集束化治疗的依从性对严重脓毒症患者医院死亡率的影响:一项前瞻性观察性研究。
Crit Care. 2005;9(6):R764-70. doi: 10.1186/cc3909. Epub 2005 Nov 11.
2
Sepsis change bundles: converting guidelines into meaningful change in behavior and clinical outcome.脓毒症变革集束:将指南转化为行为和临床结局的有意义改变。
Crit Care Med. 2004 Nov;32(11 Suppl):S595-7. doi: 10.1097/01.ccm.0000147016.53607.c4.
3
Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock.拯救脓毒症运动:严重脓毒症和脓毒性休克管理指南
Crit Care Med. 2004 Mar;32(3):858-73. doi: 10.1097/01.ccm.0000117317.18092.e4.
4
Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock.拯救脓毒症运动:严重脓毒症和脓毒性休克管理指南
Intensive Care Med. 2004 Apr;30(4):536-55. doi: 10.1007/s00134-004-2210-z. Epub 2004 Mar 3.
5
Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycemic control.重症患者强化胰岛素治疗的预后益处:胰岛素剂量与血糖控制
Crit Care Med. 2003 Feb;31(2):359-66. doi: 10.1097/01.CCM.0000045568.12881.10.
6
Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock.低剂量氢化可的松和氟氢可的松治疗对感染性休克患者死亡率的影响。
JAMA. 2002 Aug 21;288(7):862-71. doi: 10.1001/jama.288.7.862.
7
Early goal-directed therapy in the treatment of severe sepsis and septic shock.早期目标导向治疗在严重脓毒症和脓毒性休克治疗中的应用
N Engl J Med. 2001 Nov 8;345(19):1368-77. doi: 10.1056/NEJMoa010307.
8
Efficacy and safety of recombinant human activated protein C for severe sepsis.重组人活化蛋白C治疗严重脓毒症的疗效与安全性
N Engl J Med. 2001 Mar 8;344(10):699-709. doi: 10.1056/NEJM200103083441001.
9
Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome.与传统潮气量相比,采用较低潮气量对急性肺损伤和急性呼吸窘迫综合征进行通气治疗。
N Engl J Med. 2000 May 4;342(18):1301-8. doi: 10.1056/NEJM200005043421801.