The Journal of Emergency Medicine
Volume 38, Issue 2 , Pages 122-132 , February 2010

Standardization of Severe Sepsis Management: A Survey of Methodologies in Academic and Community Settings

  • H. Bryant Nguyen, MD, MS

      Affiliations

    • Department of Emergency Medicine, Loma Linda University, Loma Linda, California
    • Department of Medicine, Division of Pulmonary and Critical Care Medicine, Loma Linda University, Loma Linda, California
    • Corresponding Author InformationReprint Address: H. Bryant Nguyen, md, ms, Department of Emergency Medicine, Loma Linda University Medical Center, 11234 Anderson Street, Rm A108, Loma Linda, CA 92354
    • ,
  • Jason Oh, MD

      Affiliations

    • Department of Emergency Medicine, University of Maryland, Baltimore, Maryland
    • ,
  • Ronny M. Otero, MD

      Affiliations

    • Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan
    • ,
  • Kristy Burroughs, BS

      Affiliations

    • Department of Emergency Medicine, Loma Linda University, Loma Linda, California
    • ,
  • William A. Wittlake, MD

      Affiliations

    • Department of Emergency Medicine, Loma Linda University, Loma Linda, California
    • ,
  • Stephen W. Corbett, MD, PHD

      Affiliations

    • Department of Emergency Medicine, Loma Linda University, Loma Linda, California

Received 30 August 2007 ,Revised 10 October 2007 ,Accepted 23 October 2007.

References 

  1. Kumar A, Roberts D, Wood KE, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006;34:1589–1596
  2. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368–1377
  3. Annane D, Sebille V, Charpentier C, et al. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288:862–871
  4. Bernard GR, Vincent JL, Laterre PF, et al. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2001;344:699–709
  5. van den Berghe G, Wouters P, Weekers F, et al. Intensive insulin therapy in the critically ill patients. N Engl J Med. 2001;345:1359–1367
  6. Van den Berghe G, Wilmer A, Hermans G, et al. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354:449–461
  7. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome (The Acute Respiratory Distress Syndrome Network). N Engl J Med. 2000;342:1301–1308
  8. Dellinger RP, Abraham E, Bernard G, Marshall JC, Vincent JL. Controversies in sepsis clinical trials: proceedings of a meeting of the International Sepsis Forum, Lausanne, Switzerland, September 29, 2001. J Crit Care. 2006;21:38–47
  9. Waxman AB, Ward N, Thompson T, et al. Roundtable debate: controversies in the management of the septic patient—desperately seeking consensus. Crit Care. 2005;9:E1
  10. Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Crit Care Med. 2004;32:858–873
  11. Dellinger RP, Carlet JM, Masur H, et al. Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock. Intensive Care Med. 2004;30:536–555
  12. Nguyen HB, Rivers EP, Abrahamian FM, et al. Severe sepsis and septic shock: review of the literature and emergency department management guidelines. Ann Emerg Med. 2006;48:28–54
  13. Reinhart K, Brunkhorst F, Bone H, et al. Diagnosis and therapy of sepsis (Guidelines of the German Sepsis Society Inc. and the German Interdisciplinary Society for Intensive and Emergency Medicine). [German] Internist (Berl). 2006;47:356;358–60, 362–8, passim
  14. Pottecher T, Calvat S, Dupont H, Durand-Gasselin J, Gerbeaux P. Haemodynamic management of severe sepsis: recommendations of the French Intensive Care Societies (SFAR/SRLF) Consensus Conference, 13 October 2005, Paris, France. Crit Care. 2006;10:311
  15. Hollenberg SM, Ahrens TS, Annane D, et al. Practice parameters for hemodynamic support of sepsis in adult patients: 2004 update. Crit Care Med. 2004;32:1928–1948
  16. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Intensive Care Med. 2003;29:530–538
  17. Jones AE, Kline JA. Use of goal-directed therapy for severe sepsis and septic shock in academic emergency departments. Crit Care Med. 2005;33:1888–1889author reply 1889–90
  18. De Miguel-Yanes JM, Andueza-Lillo JA, Gonzalez-Ramallo VJ, Pastor L, Munoz J. Failure to implement evidence-based clinical guidelines for sepsis at the ED. Am J Emerg Med. 2006;24:553–559
  19. Carlbom DJ, Rubenfeld GD. Barriers to implementing protocol-based sepsis resuscitation in the emergency department—results of a national survey*. Crit Care Med. 2007;[epub ahead of print]
  20. Trzeciak S, Dellinger RP, Abate NL, et al. Translating research to clinical practice: a 1-year experience with implementing early goal-directed therapy for septic shock in the emergency department. Chest. 2006;129:225–232
  21. Shapiro NI, Howell MD, Talmor D, et al. Implementation and outcomes of the Multiple Urgent Sepsis Therapies (MUST) protocol. Crit Care Med. 2006;34:1025–1032
  22. Micek ST, Roubinian N, Heuring T, et al. Before-after study of a standardized hospital order set for the management of septic shock. Crit Care Med. 2006;34:2707–2713
  23. Nguyen HB, Corbett SW, Steele R, et al. Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality. Crit Care Med. 2007;35:1105–1112
  24. Sepsis bundle: Surviving Sepsis Campaign and Institute for Healthcare Improvement. http://www.ihi.org/IHI/Topics/CriticalCare/Sepsis 2005Accessed May 2007
  25. Gao F, Melody T, Daniels DF, Giles S, Fox S. The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study. Crit Care. 2005;9:R764–R770
  26. McCaig LF, Nawar EW. National Hospital Ambulatory Medical Care Survey: 2004. emergency department summary. Adv Data. 2006;(372):1–29
  27. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference. definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med. 1992;20:864–874
  28. Rello J, Lorente C, Bodi M, Diaz E, Ricart M, Kollef MH. Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia?: a survey based on the opinions of an international panel of intensivists. Chest. 2002;122:656–661
  29. Simpson SH, Marrie TJ, Majumdar SR. Do guidelines guide pneumonia practice? (A systematic review of interventions and barriers to best practice in the management of community-acquired pneumonia). Respir Care Clin N Am. 2005;11:1–13
  30. Majumdar SR, Simpson SH, Marrie TJ. Physician-perceived barriers to adopting a critical pathway for unity-acquired pneumonia. Jt Comm J Qual Saf. 2004;30:387–395
  31. Gallagher EJ. How well do clinical practice guidelines guide clinical practice?. Ann Emerg Med. 2002;40:394–398
  32. Buist MD, Moore GE, Bernard SA, Waxman BP, Anderson JN, Nguyen TV. Effects of a medical emergency team on reduction of incidence of and mortality from unexpected cardiac arrests in hospital: preliminary study. BMJ. 2002;324:387–390
  33. Bellomo R, Goldsmith D, Uchino S, et al. Prospective controlled trial of effect of medical emergency team on postoperative morbidity and mortality rates. Crit Care Med. 2004;32:916–921
  34. Sebat F, Johnson D, Musthafa AA, et al. A multidisciplinary community hospital program for early and rapid resuscitation of shock in nontrauma patients. Chest. 2005;127:1729–1743
  35. Armstrong R, Salfen SJ. Results of implementing a rapid response team approach in treatment of shock in a community hospital. Presented at the 43rd Annual Meeting of the Infectious Diseases Society of America, San Francisco, CA, October 2005.
  36. Lidsky NM, Joffe A, Hodgman T, et al. Time to implementation of early goal-directed therapy (EGDT) for patients with septic shock is reduced by a multidisciplinary sepsis team. Crit Care Med. 2005;33:A160
  37. Otero RM, Nguyen HB, Huang DT, et al. Early goal-directed therapy in severe sepsis and septic shock revisited: concepts, controversies, and contemporary findings. Chest. 2006;130:1579–1595
  38. Kortgen A, Niederprum P, Bauer M. Implementation of an evidence-based “standard operating procedure” and outcome in septic shock. Crit Care Med. 2006;34:943–949
  39. Gaieski D, McCoy J, Zeserson E, Goyal M. Mortality benefit after implementation of early goal directed therapy protocol for the treatment of severe sepsis and septic shock. Ann Emerg Med. 2005;46:4
  40. Verceles A, Schwarcz RM, Birnbaum P. S.E.P.S.I.S.: sepsis education plus successful implementation and sustainability in the absence of a rapid response team. Chest. 2005;128:181S–182S
  41. Rogove H, Pyle K. Collaboration for instituting the surviving sepsis campaign in a community hospital. Crit Care Med. 2005;33:110S
  42. Stenstrom RJ, Hollohan K, Nebre R. Impact of a sepsis protocol for the management of patients with severe sepsis and septic shock in the emergency department. Can J Emerg Med. 2006;2006:S16
  43. Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303–1310
  44. Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348:1546–1554

PII: S0736-4679(08)00179-0

doi: 10.1016/j.jemermed.2007.10.087

The Journal of Emergency Medicine
Volume 38, Issue 2 , Pages 122-132 , February 2010

Article Tools

* Image Usage & Resolution