Carrillo ER, Sánchez ZMJ, Arch TE, Leal GP, Salazar LMT, González S

Language: Spanish
References: 12
Page: 256-265
PDF size: 119.01 Kb.

ABSTRACT

Background: Severe sepsis and septic shock are one of the most common causes for admission to the Intensive Care Unit (ICU), with an elevated morbimortality and costs of care. Objective: To describe our experience in the management of severe sepsis and septic shock according to the Surviving Sepsis Campaign and use of Human Recombinant Activated C Protein (hrACP) in the ICU of the Médica Sur Hospital. Methods: Is a descriptive and longitudinal study, where was included all the patients that entered at ICU around one year period, with severe sepsis or septic shock with an APACHE II score › 25 and/or two or more organic dysfunctions that is was managed according to the recommendations of the Surviving Sepsis Campaign in its 2008 version and with hrACP. Results: We included 20 patients, 50% arrived at ICU with severe sepsis and 50% with septic shock. The overall mortality in severe sepsis was 30%, with 50% mortality in septic shock and 10% mortality in severe sepsis. Forty percent of the patients had 5 organics dysfunctions at the arrival to ICU. The bundles for sepsis were achieved in 88.25% of the patients, being a medial arterial pressure › 65 mmHg the most frequent goal. The use of hrACP reduced with statistical significance APACHE and SOFA scores and requirements of vasopressors and inotropics, and was associated with an increase in oxygenation index during infusion. Conclusion: Management of severe sepsis and septic shock according to Surviving Sepsis Campaign and hrACP at the ICU of Médica Sur Hospital was associated with significance reduction of mortality compared with the reports worldwide. Achievement of bundles for sepsis is high compared with international standard which are 60%. This reflects a high quality and efficiency in the attention of critical care patients with sepsis at the ICU of our institution.

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