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Title: The utilization of the surviving sepsis campaign care bundles in the treatment of pediatric patients with severe sepsis or septic shock in a resource-limited environment: A prospective multicenter trial
Authors: Rujipat Samransamruajkit
Kawiwan Limprayoon
Rojanee Lertbunrian
Rattapon Uppala
Chutima Samathakanee
Pravit Jetanachai
Nopparat Thamsiri
Chulalongkorn University
Vajira Hospital
Khon Kaen University
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
Queen Sirikit National Institute of Child Health
Hat Yai Hospital
Keywords: Medicine
Issue Date: 1-Dec-2018
Citation: Indian Journal of Critical Care Medicine. Vol.22, No.12 (2018), 846-851
Abstract: © 2018 Medknow Publications. All rights reserved. Background: Sepsis is a common condition affecting the lives of infants and children worldwide. Although implementation of the surviving sepsis campaign (SSC) care bundles was once believed to be effective in reducing sepsis mortality rates, the approach has recently been questioned. Methods: The study was a prospective, interventional, multicenter trial. Infants and children aged 1 month to 15 years in seven different large academic centers in Thailand who had been diagnosed with severe sepsis or septic shock. They were given treatment based on the SSC care bundles. Results: A total of 519 children with severe sepsis or septic shock were enrolled in the study. Among these, 188 were assigned to the intervention group and 331 were recruited to the historical case-control group. There were no significant differences in the baseline clinical characteristics. The intervention group was administered a significantly higher fluid bolus than was the control group (28.3 ± 17.2 cc/kg vs. 17.7 ± 10.6 cc/kg; P = 0.02) with early vasopressor used (1.5 ± 0.7 h) compared to control group (7.4 ± 2.4 h, P < 0.05). More importantly, our sepsis mortality reduced significantly from 37% ± 20.7% during the preintervention period to 19.4% ± 14.3% during the postintervention period (P < 0.001). Conclusion: Our study demonstrated a significant reduction in sepsis mortality after the implementation of the SSC care bundles. Early diagnosis of the disease, optimum hemodynamic resuscitation, and timely antibiotic administration are the key elements of sepsis management.
ISSN: 1998359X
Appears in Collections:Scopus 2018

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