Abstract Objectives To study the impact of the implementation of the Pediatric Surviving
Sepsis Campaign protocol on early recognition of
sepsis , 1 -h
treatment bundle and
mortality .
Methods Retrospective, single-center study, before and after the implementation of the
sepsis protocol.
Outcomes: sepsis recognition,
compliance with the 1 -h bundle (fluid
resuscitation ,
blood culture ,
antibiotics ),
time interval to fluid
resuscitation and
antibiotics administration , and
mortality .
Patients with
febrile neutropenia were excluded. The comparisons between the periods were performed using non-parametric tests and
odds ratios or
relative risk were calculated. Results We studied 84
patients before and 103 after the protocol implementation. There was an increase in
sepsis recognition (OR 21.5 [95% CI 10.1-45.7]), in the
compliance with the 1 -h bundle as a whole (62% x 0%), and with its three components fluid
resuscitation (OR 31.1 [95% CI 3.9−247.2]),
blood culture (OR 15.9 [95% CI 3.9−65.2]), and
antibiotics (OR 35.6 [95% CI 8.9−143.2]). Significant reduction between
sepsis recognition to fluid
resuscitation (152min × 12min, p < 0.001) and to
antibiotics administration (137min × 30min) also occurred. The
risk of
death before protocol implementation was four times greater (RR 4.1 [95% CI 1.2-14.4]), and the absolute
death risk reduction was 9%. Conclusion Even if we considered the low precision of some estimates, the lower limits of the
Confidence Intervals show that the implementation of the Pediatric Surviving
Sepsis Campaign guidelines alongside a qualitive assurance initiative has led to improvements in
sepsis recognition,
compliance with the 1 -h
treatment bundle, reduction in the
time interval to fluid
resuscitation and
antibiotics , and reduction in
sepsis mortality .