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Support Care Cancer. 2013 Mar;21(3):727-34. doi: 10.1007/s00520-012-1572-y. Epub 2012 Sep 7.

Implementation of modified early-goal directed therapy for sepsis in the emergency center of a comprehensive cancer center.

Author information

1
Division of Pharmacy, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. khanzelka@mdanderson.org

Abstract

PURPOSE:

The investigation examines the impact of a standardized sepsis order set and algorithm utilizing non-invasive monitoring for early-goal directed therapy (EGDT) in an emergency center setting on the clinical outcomes of sepsis in cancer patients.

METHODS:

Single-center, retrospective study comparing clinical outcomes of sepsis before and after routine usage of a standardized order set and algorithm for non-invasive elements of EGDT for sepsis in an emergency center of a comprehensive cancer center. The outcomes measures evaluated were 28-day in-hospital mortality, intensive care unit length of stay, hospital length of stay, goal mean arterial pressure and urine output within the first 6 h of treatment, time to measurement of lactic acid, and appropriateness and timeliness of initial antibiotic therapy.

RESULTS:

The 28-day in-hospital mortality was significantly lower in the post-intervention group compared to the pre-intervention group (20 vs. 38%, p = 0.005). The percentages of patients who reached their goal mean arterial pressure (74 vs. 90%, p = 0.004) and goal urine output (79 vs. 96%, p = 0.002) during the first 6 h of treatment were higher the after than the before group. No significant differences were detected in the rest of the outcome measures.

CONCLUSIONS:

Implementation of a standardized sepsis order set and algorithm to improve compliance with the non-invasive elements of EGDT for sepsis in cancer patients in the emergency center setting was associated with a decreased 28-day in-hospital mortality rate.

PMID:
22956191
DOI:
10.1007/s00520-012-1572-y
[Indexed for MEDLINE]
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