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Objective To investigate the effects of sepsis bundles in China.Method An observational study of 43 patients with severe pneumonia and septic shock admitted to the respiratory intertive care unit(1/11/2006-31/12/2007)was carried out.The selection criteria were in accordance with criteria set by International Conference On Sepsis in 2001.Implementation of 6 hours and 24 hours sepsis bundles was divided into 3 continu-ous phases consisting of education,trial,and application phase.A cohort of 43 patients with matched disease his-tory(1/1/2004-31/10/2006)was enrolled as control group.The percentages for categorical variables and mean±SD for continuous variables were reported.Chi-Square test.unpaired Student's t -test.paired-samples t test,univariate and multivariate logistic regression models were used.Statistical significance was defined as P＜0.05.Results There were very little significant differences in basic characteristics of patients between the two groups.Compared with control group,the differences in serrum lactate,fluid resuscitation and fluid volume infused within 6 hours and blood glucose control in shock subgroup were significant(P values were 0.024,0.009,0.045,and 0.000,respectively).Compared with control group,the differences in respiratory rate and oxygenation index of bundles group at 72 hours later were significant(P values were 0.033 and 0.041,respectively).Compared with control group,the differences in APACHE Ⅱ score and predicted mortality in shock subgroup of bundles were sig-nificant(P values were 0.017 and 0.040,respectively).Compared with control group,the reduction in absolute mortality was 23.30% in bundles group(P=0.019).Conclusions Implementation of sepsis bundles con-tributes noticeably to the significant reduction in mortality of patients with severe pneumonia and septic shock.
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<p><b>OBJECTIVE</b>To summarize the clinical features of severe acute respiratory syndrome (SARS) and to discuss diagnosis and management of the disease.</p><p><b>METHODS</b>A retrospective study was conducted on 78 cases of SARS referred to the Guangzhou Institute of Respiratory Diseases(GIRD) between December 22, 2002 and near the end of March 2003. Items reviewed cover all data concerning clinical manifestations, laboratory investigation and radiology.</p><p><b>RESULTS</b>The patients on the study consisted of 42 males and 36 females, aged 20-75 yrs (mean age 37.5 +/- 11.6 yrs), including 44 affected health-care professionals. Clinical symptoms seen in the group were fever (100.0%), cough (88.5%), and dyspnea (79.5%). There were 12 cases (15.3%) with WBCs < 4.0 x 10(9) /L, 49 cases (62.8%) ranging between (4.0 -10.0) x 10(9) /L and 17 cases (21.8%) over 10.0 x 10(9) /L. The average was (7.58 +/- 4.96) x 10(9) /L, with 0.75 +/- 0.14 (neutrophil) and 0.18 +/- 0.11 (lymphocyte). Chest films and CT scanning revealed changes related to pneumonia. The transmission of the disease was likely via close contact with contagious droplets. The prevalences of acute lung injury (ALI, in 37 cases) and acute respiratory distress syndrome (ARDS, 21 out of 37 cases) were considerably high among the patients. Seven patients who developed ARDS complicated with multiple organs dysfunction syndrome (MODS) died.</p><p><b>CONCLUSIONS</b>A history of close contact, fever, sign of pneumonia by X-ray and normal-to-lowered WBC counts are favorable for the diagnosis of SARS. Recognition of ALI as the important index for critical SARS and comprehensive supportive management are of paramount in decreasing the mortality of the disease.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Severe Acute Respiratory Syndrome , Diagnosis , TherapeuticsABSTRACT
OBJECTIVE:To evaluate the clinical efficacy and safety of guaifenesin,pseudoephedrine hydrochloride- codeine phosphate oral solution in relieving cough,eliminating phlegm,relieving nasal stuffiness and other cold symptoms. METHODS:A total of 240 patients with cold symptoms(120 cases in trial group and another 120 cases in control group) were enrolled in our multicenter,randomized,double-blinded and parallel controlled study and treated with guaifenesin-pseudoephedrine hydrochloride-codeine phosphate oral solutionI or compound codeine phosphate liquor 10mL tid for(5?2)d.RESULTS:227(112 in trial group and 115 in control group) were the valid cases with completed trial.Compared with pre-treatment,both of the 2 groups had a significant improvement in symptoms including cough,expectoration and nasal stuffiness after treatment(P