| A survey of clinicians addressing the approach to the management of severe sepsis and septic shock in the United States. | |
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MedLine Citation:
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PMID: 20646900 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Mortality in severe sepsis and septic shock (SS/SS) remains high. Surviving Sepsis Campaign (SSC) guidelines were published in 2004 with the goal of improving outcomes in SS/SS. We tested the hypothesis that adherence to SSC guidelines and management of patients with SS/SS were influenced by physician specialty. MATERIALS AND METHODS: A survey was mailed to 4998 randomly selected physicians, 1666 each for emergency medicine (EM), critical care medicine (CCM), and internal medicine (IM) from the American Medical Association database. Demographics, compliance with SSC guidelines, and approaches to management of patients with SS/SS were analyzed by specialty. RESULTS: Four hundred ninety-nine respondents were included for final analysis. There were no differences between 3 specialties in obtaining blood cultures and in administering intravenous fluids, pressors, and antibiotics. The CCM physicians were more likely to measure serum lactate and central venous pressure, use corticosteroids and drotrecogin α, and aim for normoglycemia and plateau pressures less than 30 cm H(2)O in mechanically ventilated patients (all P < .001). CONCLUSIONS: We observe that adherence with SSC guidelines continues to be a challenge for CCM, IM, and EM physicians. Significant differences in management of SS/SS exist for the 3 specialties. Because guideline implementation impacts patient outcomes, further evaluation of these differences is warranted. |
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Authors:
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Svetolik Djurkovic; Juan C Baracaldo; Jose A Guerra; Jennifer Sartorius; Marilyn T Haupt |
Publication Detail:
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Type: Journal Article Date: 2010-06-19 |
Journal Detail:
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Title: Journal of critical care Volume: 25 ISSN: 1557-8615 ISO Abbreviation: J Crit Care Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-26 Completed Date: 2011-01-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8610642 Medline TA: J Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 658.e1-6 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Geisinger Medical Center, Danville, PA 17822, USA. sdjurkovic1@gesinger.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Critical Care* Education, Medical Education, Medical, Continuing Emergency Medicine* Guideline Adherence Humans Internal Medicine* Physician's Practice Patterns / statistics & numerical data* Practice Guidelines as Topic Professional Practice Location Questionnaires Sepsis / therapy* Shock, Septic / therapy* United States |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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