Early recognition of sepsis and septic shock: comparison before and after implantation of protocol managed in pediatric hospital

Autores: Iracema de C O F Fernandes1, Jose Carlos Fernandes1, Ana Caroline Iglesias1, Christina de Paola1, Katia C F Millares1, Mario P Gimenez1, Renata Ferreira1, Vanessa C Gomes1
1Unidade de Terapia Intensiva, Hospital São Luiz Unidade Jabaquara – São Paulo (SP), Brasil

Objective: To compare the number of early diagnosed cases of sepsis and septic shock, before and after implantation of a protocol in a pediatric institution.

Methods: The study was carried out in 2 phases: first phase was carried a data review obtained in the period of 10 months pre-implantation of the protocol, by Epimed, from September 2015 to June 2016. The second phase was prospective, with data obtained in the Period of 10 months, from July 2016 to April 2017. The protocol and diagnosis were opened at the Pediatric Emergency Room, Inpatient Unit and at the Pediatric Intensive Care Unit. The  ntensive Care Unit has 15 general beds (clinical and surgical).

Results: From September 2015 to June 2016, Epimed data showed 388 hospitalizations in the Pediatric Intensive Care Unit, of which 25 (6.5%) patients were diagnosed with septic shock at admission, and mortality in this period was 24 % (6 patients). After the protocol was implemented, from July 2016 to April 2017, 536 patients were interviewed, 113 children (21%) met the criteria, of which the diagnosis of sepsis / shock was confirmed in 20 patients (17.6%). The mortality in this period 0.88% (2 patients).

Conclusion: Due to the need to reduce the morbidity and mortality rate in sepsis and pediatric septic shock, in addition to high costs and the difficulty of early recognition, the implementation of a managed sepsis protocol provides education and changes in early recognition and consequently improves outcome and prognosis.