Establishment of SEP-1 national practice guidelines does not impact fluid administration for septic shock patients
Boccio E, Haimovich A, Jacob V, Zhao X, Wira CR, Venkatesh A, Belsky J. Establishment of SEP-1 national practice guidelines does not impact fluid administration for septic shock patients. The American Journal Of Emergency Medicine 2022, 62: 19-24. PMID: 36209655, DOI: 10.1016/j.ajem.2022.09.038.Peer-Reviewed Original ResearchConceptsSeptic shock patientsShock patientsFluid administrationFluid managementSevere sepsis/septic shockSepsis/septic shockEarly Management BundleRetrospective observational analysisDate of presentationNational practice guidelinesUrban academic centerNational quality measuresLogistic regression analysisOdds of complianceHigh-quality careSepsis severityPrimary outcomeSeptic shockED settingResuscitation strategiesBlood culturesPractice patternsOdds ratioPractice guidelinesProvider practicesEffect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis
Sevransky J, Rothman R, Hager D, Bernard G, Brown S, Buchman T, Busse L, Coopersmith C, DeWilde C, Ely E, Eyzaguirre L, Fowler A, Gaieski D, Gong M, Hall A, Hinson J, Hooper M, Kelen G, Khan A, Levine M, Lewis R, Lindsell C, Marlin J, McGlothlin A, Moore B, Nugent K, Nwosu S, Polito C, Rice T, Ricketts E, Rudolph C, Sanfilippo F, Viele K, Martin G, Wright D, Nugent K, Spainhour C, Polito C, Moore B, Negrin L, Khan A, Kea B, Krol O, Haq E, Pinkert V, Nguyen K, Brown S, Bledsoe J, Peltan I, Applegate D, Armbruster B, Montgomery Q, Brown K, Daw A, Gong M, Aboodi M, Chen J, Hope A, Gummadi S, Lopez B, Hinson J, Hager D, Ricketts E, Clements C, Gajic O, Kashyap R, Vanmeter D, Busse L, McBride M, Ginde A, Moss M, Finck L, Howell M, McKeehan J, Higgins C, Clare J, McBryde B, Barksdale A, Kalin D, Kruse D, Hilz K, Qadir N, Chang S, Beutler R, Tam A, Harris E, Youngquist S, Middleton E, Davidov E, Plante A, Belsky J, Siner J, Wira C, Brokowski C, Steingrub J, Smithline H, Thornton-Thompson S, Fowler A, Miller S, Narron K, Puskarich M, Prekker M, Hendrickson A, Quinn J, Wilson J, Levitt J, Mann R, Visweswaran A, Gentile N, Marchetti N, Reimer H, Guirgis F, Jones L, Black L, Henson M, Meyer N, Greenwood J, Ittner C, Rivers E, Jayaprakash N, Gardner-Gray J, Hurst G, Pflaum J, Jaehne A, Gill J, Cook A, Janz D, Vonderhaar D, Romaine C, Wilkerson R, McCurdy M, Beach D, Lasko K, Gill R, Price K, Dickson L, Duggal A, Mace S, Hite R, Hastings A, Haukoos J, Douglas I, Trent S, Lyle C, Cupelo A, Gravitz S, Hiller T, Oakes J, LoVecchio F, Quiroga P, Danley S, Mulrow M, Encinas A, Goodwin A, Hall G, Grady A, Exline M, Terndrup T, Pannu S, Robart E, Karow S, Files D, Smith L, Gibbs K, Flores L, Pastores S, Shaz D, Kostelecky N, Case C, Wilkins E, Gaieski D, Baram M, Schwegler D, Renzi N, Mosier J, Hypes C, Campbell E, Hooper M, Sill J, Mitchell K, Hudock K, Lyons M, Gorder K, Ahmad Y, Studer A, Davis J, Barrett M, Nomura J, Knox J, Park P, Co I, McSparron J, Hyzy R, McDonough K, Hanna S, Self W, Semler M, Hays M, Bartz R, Limkakeng A, Sweeney K, Woodburn R, Goyal M, Zaaqoq A, Moriarty T, Oropello J, Zhang Z. Effect of Vitamin C, Thiamine, and Hydrocortisone on Ventilator- and Vasopressor-Free Days in Patients With Sepsis. JAMA 2021, 325: 742-750. PMID: 33620405, PMCID: PMC7903252, DOI: 10.1001/jama.2020.24505.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnti-Inflammatory AgentsAscorbic AcidCritical IllnessDouble-Blind MethodDrug Therapy, CombinationEarly Termination of Clinical TrialsFemaleHumansHydrocortisoneLength of StayMaleMiddle AgedOrgan Dysfunction ScoresRespiration, ArtificialRespiratory InsufficiencySepsisThiamineTreatment OutcomeVasoconstrictor AgentsVitaminsConceptsVasopressor-free daysIntensive care unitVitamin CPlacebo groupCare unitIntervention groupDays of randomizationIntravenous vitamin CPlacebo-controlled trialThirty-day mortalityTotal daily doseKey secondary outcomesAdult patientsSecondary outcomesDaily doseIll patientsPrimary outcomeSubstantial morbidityCardiovascular dysfunctionEmergency departmentCommon syndromeMAIN OUTCOMESepsisPlaceboPatientsAntibiotic Delays and Feasibility of a 1-Hour-From-Triage Antibiotic Requirement: Analysis of an Emergency Department Sepsis Quality Improvement Database
Filbin MR, Thorsen JE, Zachary TM, Lynch JC, Matsushima M, Belsky JB, Heldt T, Reisner AT. Antibiotic Delays and Feasibility of a 1-Hour-From-Triage Antibiotic Requirement: Analysis of an Emergency Department Sepsis Quality Improvement Database. Annals Of Emergency Medicine 2019, 75: 93-99. PMID: 31561998, DOI: 10.1016/j.annemergmed.2019.07.017.Peer-Reviewed Original ResearchConceptsQuality improvement interventionsHours of triageAntibiotic delaySeptic patientsImprovement interventionsAntibiotic requirementsLower Sequential Organ Failure Assessment scoresSequential Organ Failure Assessment scoreMedicaid Services Severe SepsisOrgan Failure Assessment scoreSurviving Sepsis Campaign recommendationsMost septic patientsOnset of hypoperfusionSurviving Sepsis CampaignAdult septic patientsQuality improvement databaseNational quality measuresMedicaid Services measuresTriage locationInfectious symptomsSevere sepsisChart reviewMost patientsSepsis CampaignPrimary outcome