Adherence to the guidelines for the management of severe sepsis and septic shock in patients over 65 years of age admitted to the ICU
Introduction: The use of guidelines for goal-oriented resuscitation in patients with severe sepsis and septic shock has a positive impact on multiple organ failure and mortality outcomes. However, in patients over 65, adherence to the guidelines may be less stringent because of considerations of lower functional, cardiac, pulmonary and renal reserve. This study compares adherence to the guidelines and compliance with resuscitation goals by the healthcare staff in populations over and under 65 years of age.
Objective: To determine adherence to the guidelines by the healthcare staff in the treatment of severe sepsis and septic shock in the group over 65 years of age, compared with patients under 65.
Materials and methods: Observational, analytical, cross-sectional study of patients under and over 65 years of age admitted to the Intensive Care Unit (ICU) after having been diagnosed with severe sepsis and septic shock. Frequency of adherence to the guidelines was determined and a comparison of the different resuscitation goals in relation to adherence to the guidelines was made.
Results: Except for adherence to early initiation of antibiotic therapy, there was better adherence to the other goals in the patients under 65 when compared to patients over 65. Adherence to the guidelines declined progressively as the number of goals increased.
Conclusions: There was a lower adherence to resuscitation guidelines in the group of patients over 65 with severe sepsis and septic shock when compared with the group of patients under 65.
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