成人败血症代码:对其实施和影响的叙述性回顾。

IF 3 3区 医学 Q2 CRITICAL CARE MEDICINE Journal of Intensive Care Medicine Pub Date : 2024-11-03 DOI:10.1177/08850666241293034
Andrés Giglio, María Aranda, Andres Ferre, Marcio Borges
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引用次数: 0

摘要

脓毒症代码协议是一种旨在改善脓毒症患者临床疗效的紧急干预策略,本叙述性综述探讨了该协议的实施情况和影响。我们研究了实施程度、启动标准、实施领域、参与人员、启动后的反应、目标和指标、对临床指标的影响以及实施过程中的挑战。所审查的证据表明,脓毒症代码可以显著降低脓毒症相关死亡率,并加强早期治疗。然而,启动标准的多变性和应用的不一致性带来了持续的挑战。本综述考虑了纳入较新评分系统(如 NEWS 和 MEWS)的问题,以及整合机器学习工具用于早期脓毒症检测的可能性。它强调了根据具体的医疗环境调整实施方案的重要性,以及持续培训对优化脓毒症应对措施的价值。局限性包括围绕脓毒症定义的持续争议,以及需要标准化、可行的质量指标。未来的研究应重点关注启动标准的标准化、协议遵守情况的改善以及新兴技术的探索,以加强早期脓毒症的检测和管理。尽管存在挑战,但如果能在医疗机构中周到、一致地实施脓毒症代码,则有望改善患者的预后。
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Adult Code Sepsis: A Narrative Review of its Implementation and Impact.

This narrative review explores the implementation and impact of sepsis code protocols, an urgent intervention strategy designed to improve clinical outcomes in patients with sepsis. We examined the degree of implementation, activation criteria, areas of implementation, personnel involved, responses after activation, goals and targets, impact on clinical indicators, and challenges in implementation. The reviewed evidence suggests that sepsis codes can significantly reduce sepsis-related mortality and enhance early administration of treatments. However, variability in activation criteria and inconsistent application present ongoing challenges. The review considers the incorporation of newer scoring systems, such as NEWS and MEWS, and the potential integration of machine learning tools for early sepsis detection. It highlights the importance of tailoring implementation to specific healthcare contexts and the value of ongoing training to optimize sepsis response. Limitations include the ongoing controversy surrounding sepsis definitions and the need for standardized, feasible quality indicators. Future research should focus on standardizing activation criteria, improving protocol adherence, and exploring emerging technologies to enhance early sepsis detection and management. Despite challenges, sepsis codes show promise in improving patient outcomes when implemented thoughtfully and consistently across healthcare settings.

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来源期刊
Journal of Intensive Care Medicine
Journal of Intensive Care Medicine CRITICAL CARE MEDICINE-
CiteScore
7.60
自引率
3.20%
发文量
107
期刊介绍: Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.
期刊最新文献
Adult Code Sepsis: A Narrative Review of its Implementation and Impact. Diagnostic and Therapeutic Strategies to Severe Hyponatremia in the Intensive Care Unit. Diffuse Alveolar Hemorrhage in Hematopoietic Cell Transplantation. Blood RNA Biomarkers Identify Bacterial and Biofilm Coinfections in COVID-19 Intensive Care Patients. Vitamin K Prescribing Trends Among Critically Ill Children Hospitalized for Sepsis: A Multicenter Observational Cohort Study.
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