A survey of clinicians addressing the approach to the management of severe sepsis and septic shock in the United States
A survey of clinicians addressing the approach to the management of severe sepsis and septic shock in the United States
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DOI：
10.1016/j.jcrc.2010.04.005
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发表时间：
2010-12-01
影响因子：
3.7
通讯作者：
Haupt, Marilyn T.
中科院分区：
文献类型：
--
作者：
Djurkovic, Svetolik;Baracaldo, Juan C.;Haupt, Marilyn T.
目的重症和脓毒性休克（SS/SS）的死亡率仍然很高。2004年发布了旨在改善SS/SS结局的脓毒症生存指南（SSC）。材料与方法：随机抽取4998名急诊科医生，每名1666人，EM）重症监护医学（CCM）和内科学（IM），来自美国医学会数据库人口统计学符合SSC指南和SS患者管理方法/结果共纳入499名被调查者，3个专业在血培养、静脉输液、升压药和抗生素的使用方面无差异。更可能使用皮质类固醇和屈可生α测量血清肝和中心静脉压，并针对血压正常和平台压低于30 cm H-O m的机械通气患者（直到P <0.01）结论我们观察到，遵守SSC指南仍然是CCM IM和EM医生的挑战。由于指南的实施会影响患者的结局，因此需要进一步评估这些差异。(C)2010年爱思唯尔公司版权所有
Purpose Mortality in severe and septic shock (SS/SS) remains high Surviving Sepsis Campagin (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 spectrallyMaterials 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 spectrallyResults 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 hepatic and central venous pressure use corticosteriods and droticogen alpha and aim for normoglycemia and plateau pressures less than 30 cm H-O m mechanically ventilated patients (till P < 001)Conclusions We observe that adherence with SSC guidelines continues to be a challenge for CCM IM and EM physicians Stimulant differences in management of SS/SS exist ffor the 8 specialties Because guidelines implementation impacts patient outcomes further evaluation of these differences is warrented. (C) 2010 Elsevier Inc. All rights reserved