KẾT QUẢ ÁP DỤNG GÓI ĐIỀU TRỊ NHIỄM KHUẨN HUYẾT VÀ SỐC NHIỄM KHUẨN TRONG GIỜ ĐẦU TẠI KHOA CẤP CỨU VÀ NỘI TRÚ, BỆNH VIỆN ĐA KHOA QUỐC TẾ VINMEC TIMES CITY 2019-2021

Abstract

Objective: Evaluate the application of treatment packages for sepsis and septic shock in the first hour at the emergency department and inpatient department, Vinmec Times City hospital. Research subjects and methods: Retrospective study on 86 patients with sepsis or septic shock at the emergency department and inpatient department, Vinmec Times City hospital from April 2019 to October 2021. The application of the 1-hour package is divided into two levels: compliance and non-compliance. Treatment results when applying the 1-hour package are based on clinical outcomes, acute kidney injury rate at hour 48 and day 7, duration of vasopressor use, number of days in the intensive care unit and number of days in the hospital. Results: Among 86 patients participating in the study, the proportion of women was 44.18%, average age was 72 ±  3.9 years old. Patients with septic shock accounted for 55.8% and simple sepsis accounted for 44.2%, of which the highest were pneumonia (36%), and digestive infections (30.2%). The overall compliance rate of the entire package was 59.30%, of which the highest compliance with vasopressors (100%), the lowest compliance with first hour antibiotics was 67.44%. The rate of acute kidney injury at 48 hours and day 7 in the compliant group tended to decrease faster than the non-compliant group, but the difference was not statistically significant. The criteria of number of days in the intensive care unit, number of days in the hospital, and time to recover from shock did not differ between the compliant and non-compliant groups. Conclusion: Initial research shows that compliance with the full 1-hour package according to the instructions of the Surviving sepsis campaign 2018 tends to reduce the rate of acute kidney injury faster in the group with full compliance at 48 hours and day 7. However, the number of patients studied was not large enough so the difference was not statistically significant, and the final outcome of death was no difference between the compliant and non-compliant groups.