Dana,
I hope this helps you:
v Lactic Acid >2 is Severe Sepsis associated with organ dysfunction,
hypotension, or hypoperfusion abnormalities including:
* Skin mottling or capillary refill time >3 seconds
* Urine output < 0.5 ml/kg for at least 1 h or patient requiring renal
replacement therapy
* Serum lactate >2 mmol/L
* Acute alteration of mentation or encephalopathic changes on
electroencephalogram
* Disseminated intravascular coagulation or platelets <100K cells/mL
* Acute lung injury or acute respiratory distress syndrome
v Septic Shock is Severe Sepsis PLUS
v Hypotension despite adequate fluid resuscitation OR
v Serum Lactate > 4 mmol/L
If you are just beginning to collect data you might focus on how your
institution does in getting the 3 hour bundle in for the lactate >4. I think
there needs to be more research done on implementing the 3 hours bundle when
the lactic acid is 2......but from the sepsis expedition the experts stated
these patients need fluid.....maybe not the entire 30ml/kg, but fluid and the
other elements too.
There is a study that shows the faster you get the 3 hour bundle completed the
better the outcomes. "Multicenter Implementation of Server Sepsis and Septic
Shock Treatment Bundle" By Russell R. Miller III et, al
If I miss spoke please someone correct me.
Thank you,
Amy
Amy L. Sprague MSN, RN, ACNS-BC, CCRN
Clinical Nurse Specialist~Critical Care
Franciscan St. Francis Health
8111 S. Emerson Avenue
Indianapolis, IN 46237
Office (317)528-6800
[email protected]
"People grow through experience if
they meet life honestly and courageously."
Eleanor Roosevelt,
U.S. first lady
From: [email protected]
[mailto:[email protected]] On Behalf Of DanaMarie
Smith
Sent: Friday, November 22, 2013 9:10 AM
To: [email protected]
Subject: [Sepsis Groups] Lactic Acid
Im sorry just one more question. For the Lactic Acid, I have been collecting if
its >4 as criteria for severe sepsis but I have been seeing articles saying
they are considering >2 as criteria for severe sepsis. So I guess my question
is do I count Lactic Acid >2 as severe sepsis and the Lactic Acid >4 is for the
6 hr bundle?
Thank You,
Dana
Dana Marie Smith RN
Clinical Data Analyst
Quality/Performance Improvement
Phone # 215- 612-5354
Fax # 215-612-4463
________________________________
The information contained in this e-mail and any accompanying documents is
intended for the sole use of the recipient to whom it is addressed, and may
contain information that is privileged, confidential, and prohibited from
disclosure under applicable law. If you are not the intended recipient, or
authorized to receive this on behalf of the recipient, you are hereby notified
that any review, use, disclosure, copying, or distribution is prohibited. If
you are not the intended recipient(s), please contact the sender by e-mail and
destroy all copies of the original message. Thank you.
_______________________________________________
Sepsisgroups mailing list
[email protected]
http://lists.sepsisgroups.org/listinfo.cgi/sepsisgroups-sepsisgroups.org
