Table 2. Elements of Sepsis Resuscitation.
| Sepsis Protocol (n = 106) |
Usual Care (n = 103) |
P Value | |
|---|---|---|---|
| Intravenous fluid administration, median (IQR), La | |||
| 6 h | 3.5 (2.7 to 4.0) | 2.0 (1.0 to 2.5) | <.001 |
| 24 h | 4.0 (3.0 to 5.0) | 3.0 (2.0 to 4.3) | <.001 |
| 72 h | 5.0 (3.5 to 6.5) | 4.0 (3.0 to 6.0) | .33 |
| Dopamine (vasopressor) administration, No. (%) | |||
| During first 6 h | 15 (14.2) | 2 (1.9) | .001 |
| During hospitalization | 22 (20.8) | 7 (6.8) | .004 |
| Blood transfusion, No. (%) | |||
| During first 6 h | 17 (16.0) | 13 (12.6) | .48 |
| During hospitalization | 37 (34.9) | 31 (30.1) | .46 |
| Time to antibiotics, median (IQR), h | 2.0 (0.7 to 4.1) | 1.5 (0.5 to 2.8) | .15 |
| Physiological variables, median (IQR) | |||
| Systolic blood pressure 2 h after enrollment, mm Hg | 89 (85 to 95) | 88 (83 to 92) | .09 |
| Diastolic blood pressure 2 h after enrollment, mm Hg | 55 (48 to 59) | 54 (47 to 61) | .99 |
| Systolic blood pressure 6 h after enrollment, mm Hg | 95 (90 to 104) | 96 (90 to 105) | .95 |
| Diastolic blood pressure 6 h after enrollment, mm Hg | 61 (55 to 67) | 61 (55 to 65) | .82 |
| Whole blood lactate, median (IQR), mmol/L | 3.3 (2.1 to 5.4) | 3.9 (2.1 to 6.6) | .25 |
| Change in lactic acid concentration from baseline to 6 h after enrollment, mmol/L | −1.2 (−3.4 to 0.3) | −0.5 (−2.2 to 1.1) | .02 |
| Respiratory rate increased by ≥5 breaths/min or SpO2 decreased by ≥3%, No. (%)b | 38 (35.8) | 23 (22.3) | .03 |
| Resolved by 6 h after enrollment | 20 (18.9) | 8 (7.8) | .02 |
| Persistent beyond 6 h after enrollment | 18 (17.0) | 15 (14.6) | .63 |
Abbreviations: IQR, interquartile range; SpO2, oxygen saturation by pulse oximeter.
SI conversion factor: To convert lactate to mg/dL, divide by 0.111.
a
Represents the cumulative volume of crystalloid solutions administered between emergency department registration and the 3 time points.
b
Respiratory compromise was prospectively defined as an increase in respiratory rate of at least 5 breaths per minute vs baseline or a decrease in oxygen saturation of more than 3% from baseline. Classification of respiratory compromise as either resolving by 6 hours after enrollment or persisting beyond 6 hours after enrollment was performed post hoc.