Adherencia a las guías de reanimación temprana dirigida por metas, en un hospital de Bogotá, Colombia

Abstract

Introduction: Early management of patients with severe sepsis and septic shock emergency room under the "early goal-directed therapy" proposed by Rivers in his guide "Surviving Sepsis Campain" seems to be related with a decrease in mortality in the first 28 days of care. The aim of this study was to measure the adherence to these recommendations in an emergency department of fourth level hospital. Methodology: Using adescriptive observational cross-sectional study, medical records of a group of patients with severe sepsis and septic shock who were admitted in 2013 to the emergency room of a hospital of fourth level of Bogotá, Colombia, were reviewed. The proportion of patients in wich the international recommendations were fully followed, were calculated. Correlation between adherence and proportions of mortality were estimated. Results: From 3000 records, 130 clinical records were included and evaluated. 15.4% of patients received attention according to international guidelines for early resuscitation. Mortality from severe sepsis and septic shock was 10.7%. Mortality in patients who were treated according to guidelines was 15% compared to 10% who were not (p> 0.05) Conclusions: Adherence to international recommendations proposed by Rivers are low. Educational campaigns and training for medical and paramedical staff of the emergency room should be conducted in order to improve survival in this group of patients.