My understanding is that the GNYHA protocol listed ³empiric fluid loading² as a choice. Not sure if that was a protocol. In addition, my understanding is that almost 50% of the patients in the initiative had no recorded method for fluid resuscitation. Is that correct?
Mitchell Levy On 5/1/13 3:01 PM, "Mary Daly" <[email protected]> wrote: > I am surprised that the non-inferiority study¹ referenced here would lead to > treatment protocols with endpoints that were not endorsed by the Surviving > Sepsis Campaign. > Among the flaws in that study was the arbitrary choice of a 10% reduction in > lactate levels¹. > In addition to the fact that this per cent reduction was arbitrary, I think > that we can all agree that there is quite a difference in a 10% reduction in a > lactate of 3.9 and a 10% reduction in a lactate of lactate of 8.9. > > Although the new SSC guidelines include targets for serum lactate > reduction(begrudgingly to satisfy NQF - IMHO), the goal of the reduction is > not by some arbitrary number - but normalized. > > $0.02 > Thanks, > > Mary Ann Daly, RN BSN CCRN DC > Regional Clinical Initiative Lead-Sepsis and ICU Liberation (ABCDE) > Gordon and Betty Moore Foundation Grant > Sutter Health Sacramento Sierra Region > E-mail: [email protected] <mailto:[email protected]> > Blackberry: 916.200.5604 Office: 916.614.6370 > You never change things by fighting the existing reality. To change > something, build a new model that makes the existing model obsolete. R. > Buckminster Fuller > > > > From: [email protected] > [mailto:[email protected]] On Behalf Of Ram Parekh > Sent: Tuesday, April 30, 2013 1:50 PM > To: Vipul Kella > Cc: [email protected] > Subject: Re: [Sepsis Groups] Noninvasive EGDT > > We have at our hospital and at most of the GNYHA hospitals in the New York > area. > > This protocol is based on the non-inferiority study of lactate clearance by > Jones/Shapiro and was implemented with our current Stop Sepsis collaborative > which has given ED providers the option of utilizing the 'invasive' or > 'non-invasive protocol' as EGDT options. Thus, the protocol was simultaneously > implemented in over 50 hospitals at the same time. > > On Mon, Apr 29, 2013 at 9:57 AM, Vipul Kella <[email protected]> wrote: > > Has anyone implemented the noninvasive EGDT protocol at their hospital? What > was your experience? >
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