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VOLUME 14 , ISSUE 1 ( January, 2010 ) > List of Articles

REVIEW ARTICLE

Severe sepsis bundles

Parvez Khan

Keywords : Severe Sepsis, Surviving Sepsis Campaign, Sepsis Care Bundles

Citation Information : Khan P. Severe sepsis bundles. Indian J Crit Care Med 2010; 14 (1):8-13.

DOI: 10.5005/ijccm-14-1-8

License: CC BY-ND 3.0

Published Online: 00-01-2010

Copyright Statement:  Copyright © 2010; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Sepsis is a complex syndrome with its wide spectrum of severity, and is one of the most common causes of death in Critical Care Units. The Surviving Sepsis campaign launched in 2004, is aimed at improving diagnosis, management and survival of patients with sepsis. Care bundles are a group of best evidence based interventions which when instituted together, gives maximum outcome benefit. Care Bundles are simple, uniform and have universal practical applicability. Surviving Sepsis campaign guidelines in 2008 incorporated two sepsis care bundles. The Resuscitation bundle includes seven key interventions to be achieved in 6-h while four interventions have to be completed within 24-h in the Management bundle. Compliance with a bundle implies achieving all the specified goals in that bundle. Limitations to care bundles include the quality of the evidence on which they are based, and that the relative contributions of each element of the bundle are not known. Several observational studies support the hypothesis that sepsis care bundles have an important role in improving outcomes from sepsis. Critical Care Units should develop management strategies to ensure compliance with the sepsis bundles in order to decrease hospital mortality due to severe sepsis.


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  1. Vincent JL, Martinez EO, Silva E. Evolving concepts in sepsis definitions. Crit Care Clin 2009;25:665-75.
  2. Levy MM, Fink MP, Marshall JC, Abraham E, Anus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference. Crit Care Med 2003;31:1250-6.
  3. Masterton RG. Sepsis care bundles and clinicians. Intensive Care Med 2009;35:1149-51.
  4. Surviving Sepsis Campaign implementation and the appropriate role of industry. Available from: http://www.survivingsepsis.org/ [accessed on 2010 Feb 7].
  5. Fletcher SJ, Quinn AC. The surviving sepsis campaign and sepsis care bundles: Substance or sophistry? Anaesthesia 2006;61:313-5.
  6. Severe sepsis bundles. Resuscitation bundle Available from: http://www.survivingsepsis.org/ [last accessed on 2010 Feb 7].
  7. Severe sepsis bundles. Management bundle. Available from: http://www.survivingsepsis.org/, [last accessed on 2010 Feb 7].
  8. Resar R, Pronovost P, Haraden C, Simmonds T, Rainey T, Nolan T. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. Jt Comm J Qual Patient Saf 2005;31:243-8.
  9. Levy MM, Pronovost PJ, Dellinger RP, Townsends S, Resar RK, Clemmer TP, et al. Sepsis change bundles: Converting guidelines into meaningful change in behavior and clinical outcome. Crit Care Med 2004;32:S595-7.
  10. Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, et al. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med 2008;36:296-327.
  11. 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 Med 2005;9:764-70.
  12. Levy MM, Dellinger RP, Townsend SR, Linde-Zwirble WT, Marshall JC, Bion J, et al. The Surviving Sepsis Campaign: Results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med 2010;38:367-74.
  13. Barochia AV, Cui X, Vitberg D, Suffredini AF, O′Grady NP, Banks SM, et al. Bundled care for septic shock: An analysis of clinical trials. Crit Care Med 2010;38:668-78.
  14. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early Goal directed therapy in the treatment of Severe sepsis and septic shock. N Engl J Med 2001;345:1368-77.
  15. Trzeciak S, Dellinger RP, Abate NL, Cowan RM, Stauss M, Kilgannon JH, 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;129:225-32.
  16. Kortgen A, Niederprum P, Bauer M. Implementation of an evidence-based “standard operating procedure” and outcome in septic shock. Crit Care Med 2006;34:943-9.
  17. Shapiro NI, Howell MD, Talmor D, Lahey D, Ngo L, Buras J, et al. Implementation and outcomes of the Multiple Urgent Sepsis Therapies (MUST) protocol. Crit Care Med 2006;34:1025-32.
  18. Micek ST, Roubinian N, Heuring T, Bode M, Williams J, Harrison C, et al. Before-after study of a standardized hospital order set for the management of septic shock. Crit Care Med 2006;34:2707-13.
  19. Nguyen HB, Corbett SW, Steele R, Banta J, Clark RT, Hayes SR, 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;35:1105-12.
  20. Jones AE, Focht A, Horton JM, Kline Ja. Prospective external validation of the clinical effectiveness of an emergency department-base early goal-directed therapy protocol for severe sepsis and septic shock. Chest 2007;132:425-32.
  21. El Solh AA, Akinnusi ME, Alsawalha LN, Pineda LA. Outcome of septic shock in older adults after implementation of the sepsis “bundle.” J Am Geriatr Soc 2008;56:272-8.
  22. Ferrer R, Artigas A, Levy MM, Blanco J, Gonzalez-Diaz G, Garnacho-Montero J, et al. Improvement in process of care and outcome after a multicenter severe sepsis educational program in Spain. JAMA 2008;299:2294-303.
  23. Finfer S. The Surviving Sepsis Campaign: Robust evaluation and high-quality primary research is still needed. Crit Care Med 2010;38:683-4.
  24. Sinuff T, Eva KW, Meade M, Dodek P, Heyland D, Cook D, et al. Clinical practice guidelines in the intensive care unit: A survey of Canadian clinicians′ attitudes. Can J Anaesth 2007;54:728-36.
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