Studies on Sepsis Management and Care Pathways

Authors Objective Design Methodology Results Conclusion
Adcroft
(2014)
To
investigate
processes
for
management
of sepsis
patients in
AAU
Retrospecti
ve cohort
Audit
performed for
30 patients
diagnosed
with severe
sepsis and
septic shock,
followed by
assessment of
the notes, and
comparing
them against
figures of
emergency
department
Performance
below the
national
standards for
high flow
oxygen
administration,
crystalloid fluid
boluses, lactate
measurements,
and blood
culture
Low
standards of
sepsis
management
paved the
way for the
introduction
of sepsis six
management
bundle.
Educating
healthcare
professionals
, and
increasing
awareness on
sepsis
management
showed
significant
improvement
s in patients,
after re-
audit.

Burke et
al. (2019)
To explore
the impacts
of sepsis six
bundle
administrati
on on patient
outcomes
Prospectiv
e
observatio
nal study
Introduction
of sepsis bags
and sepsis six
bundle,
followed by
their
administration
to 207 patients
who had been
admitted for
sepsis
management
84% overall
bundle
compliance.
National Early
Warning Scores
reduced
considerably 24
hours, after
Sepsis Six
administration,
from 7⋅4 ±2⋅6 to
3⋅1 ±2⋅4 (p
<0⋅001).
Reduced
mortality at 90
days amid
patients who
received the
bundle, 48 hours
after admission
Better
patient
outcomes
obtained
after sepsis
six
administratio
n to patients.
Reliable
bundle
delivery was
80%
attainable,
notwithstand
ing similarity
in baseline
variables
Deep et
al. (2013)
To observe
evolution of
SVR and
CO during
intensive
Prospectiv
e
observatio
nal study
Use of non-
invasive
ultrasound
cardiac output
monitor
88.9% general
28-day survival.
Lower ScvO2 in
community-
acquired group,
Children
with
community-
acquired
septic shock

care
treatment of
children
suffering
from fluid-
refractory
septic shock
device
(USCOM) for
studying 36
children
admitted to
ICU for 36
months,
followed by
titration of
inotrope,
inodilator and
vasopressor
when compared
to hospital-
acquired group.
Normal CI and
SVRI reported
by children in
both groups,
within 42 hours
of therapy.
reported
signs and
symptoms of
cold shock.
However,
those who
were
categorised
to hospital-
acquired
septic shock
manifested
symptoms of
warm shock.
Survival
rates for 28
days were
same in both
the groups.
Hancock
(2015)
To
determine
the efficacy
of a national
quality
improvemen
Prospectiv
e
observatio
nal study
Clinical teams
contributed
in education s
ets at where
there were
provided
All organisations
were found to
implement
advanced
treatment tools
and procedures
Collaborativ
e learning
has been
identified as
an effective
procedure

t initiative,
in lowering
death rate
and harm
from sepsis
training in
service
development
and human
factors
philosophies,
followed by
providing
support in
order to
administer
‘bundles’
based on
evidences, for
assessing both
the treatment
procedures
and outcomes.
such as, NEWS,
Patient Status at
A Glance
(PSAG) boards,
sepsis screening
tools,
antibiotic formul
ary, and sepsis
response bags.
for
enhancing
quality of
sepsis
management
Inwald et
al. (2019)
To assess
feasibility of
Fluids in
Shock for
10 mL/kg
versus 20
mL/kg fluid
Randomise
d
controlled
trial
Random
allocation of
children with
sepsis to 10 or
20 mL/kg flui
d bolus in 1;1
ratio, for 15
Fluid bolus
volume was 44%
less after 4 hours
in 10 mL/kg
group. 2.1 and
2.0 Paediatric
Index of
Children did
not report
any
symptoms of
being
unwell.