Septic shock patients, only 35 had ITU intervention within 6 hours (had CVP
Septic shock patients, only 35 had ITU intervention within 6 hours (had CVP insertion and/or started on vasopressor and/or EPZ-5676 msds inotropic support). Central venous oxygen saturation or mixed venous oxygen saturation was not measured for these patients. Conclusions Early recognition and the initial resuscitation of sepsis at this District General Hospital were assessed for the first time. Patients with severe sepsis or septic shock were not resuscitated appropriately and the SSC guidelines were not implemented, resulting in a high mortality rate. The results showed that there is a delay in recognizing sepsis at early stages resulting in inadequate management of patients. In septic shock patients, this resulted in delayed CVP measurement and administration of vasopressors and/or inotropic support. Therefore, we have suggested an educational programme running throughout the year to educate medical and nursing teams about the early recognition and management of sepsis, with emphasis on the strict implementation of all tasks of sepsis protocol according to SSC guidelines to reduce the mortality rate by 25 . We also suggest setting up critical care beds on each ward that will be supported by ITU outreach for CVP insertion and level 1 monitoring.P33 The selective V1a receptor agonist FE 202158 does not cause von Willebrand factor release in sheep unlike arginine vasopressinS Rehberg1, P Enkhbaatar1, R Laporte2, J Rehberg1, E La2, K Wisniewski2, LD Traber1, CD Schteingart2, PJM Riviere2, DL Traber1 1Investigational Intensive Care Unit, Department of Anesthesiology, The University of Texas Medical Branch, Galveston, TX, USA; 2Ferring Research Institute, Inc., San Diego, CA, USA Critical Care 2009, 13(Suppl 4):P33 (doi: 10.1186/cc8089) Introduction The mixed V1a/V2 receptor agonist arginine vasopressin (AVP) is recommended by the guidelines of the Surviving Sepsis Campaign as an adjunct vasopressor in norepinephrineresistant septic shock. However, AVP may be procoagulantBreakdown of tasks of the initial resuscitation bundle achieved within 6 hours Number of patients achieved/total number of patients 25/33 6/33 6/9 5/24 7/23 17/23 2/23 of patients where SSC recommendation was followed 76 18 67 21 30 74Initial resuscitation tasks (within 6 hours) Serum lactate measured Obtaining blood cultures prior to antibiotic administrationBroad-spectrum antibiotics within 3 hours from time of presentation for Emergency Department admissions 1 hour for non-Emergency Department ICU admissions In patients with septic shock or serum lactate >4 mmol/l (36 mg/dl) Fluid challenges Vasopressors CVP >8 mmHg in nonmechanically ventilated patients (12 to 15 in mechanically ventilated patients)SCritical CareNovember 2009 Vol 13 SupplSepsisthrough V2 receptor-mediated effects (for example, von Willebrand factor (vWF) release). Objective We hypothesized that the selective V1a receptor agonist FE 202158, which lacks the activity at the V2 receptor, might not have the procoagulant effects of AVP. This hypothesis was tested by measuring vWF antigen (vWF:Ag) activity in plasma of healthy sheep during administration of either FE 202158, AVP, the selective V2 receptor agonist desmopressin, or vehicle. Methods After measurements of vWF:Ag activity and hemoglobin concentration in blood over a 1-hour baseline period, 24 female sheep were randomly assigned to receive either PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/26740125 an intravenous bolus of the selective V2 receptor agonist desmopressin (1 nmol/kg) or a continuous intravenous in.