GPHC ICU Physicians’ Adherence to Surviving Sepsis 2021 Adult ARDSMechanical Ventilation Guidelines between June 2023-June 2024
Introduction
Surviving Sepsis 2021 is the latest evidence-based international guideline for
the management of Sepsis that boasts significant morbidity/mortality benefits. As the main
referral hospital in a developing country, there is foreseeable benefit in evaluating our
physicians’ adherence to an international standard to direct efforts and limited resources
aiming for maximal impact on patient morbidity, mortality, and healthcare system burden.
Objectives
1. To assess GPHC ICU’s Physicians’ adherence to the Surviving Sepsis 2021 Mechanical
Ventilation recommendations
2. To report specific morbidity measures (duration of inpatient stay, need for and duration
of mechanical ventilation) and inpatient mortality rates
Method
A prospective, observational descriptive study with a total population sampling of
ten patients facilitated through the GPHC Records Department and the ICU Register. A
checklist elucidating physicians’ adherence levels to mechanical ventilation parameters and
morbidity/mortality measures was applied. analysis aimed to demonstrate complete vs
incomplete physician adherence and the correlation of quartile adherence levels to specific
measures.
Results
Adherence was greatly weighted to the twenty-fifth percentile followed by the
fiftieth percentile. Comparing those subsets, a mean difference in ICU length of stay of 6.57
days (2 vs 8.57 days, SD +/- 5.18), as well as a lesser duration of mechanical ventilation ( 2 vs
7.14 days, Mean 5.7 days, SD +/- 5.17), were noted. Given the absence of completely adherent
cases and 100% mortality, correlational assessments were deferred.
Conclusion
GPHC ICU physicians scored most commonly in the twenty-fifth followed by
the fiftieth percentiles of adherence. Comparatively, there was a decrease in both length of
ICU stays and duration of mechanical ventilation; these findings represent greater concern
than benefit in the context of uniform mortality.
Recommendations
Three remedial measures: a Physician Education initiative, an
institutional protocol for the management of ARDS, and monitoring of ARDS indicators.
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