title: Implementation of the Surviving Sepsis Campaign guidelines for severe sepsis and septic shock: we could go faster.
abstract: OBJECTIVE
  The aim of this study is to evaluate the feasibility of applying sepsis bundles in the intensive care unit (ICU) and their effect on outcomes.
  
  
  METHODS
  In this prospective, observational study in a 31-bed capacity department of intensive care, we measured the time taken to perform sepsis bundle interventions in 69 consecutive patients with severe sepsis or septic shock.
  
  
  RESULTS
  Compliance with the 6-hour bundle was obtained in 44 (72%) of 61 patients; these patients had a lower mortality rate (16% vs 41%, P = .04) and shorter ICU stay (median [range], 5 [3-10] vs 9 [6-19] days, P = .01) than other patients. Compliance with the 24-hour bundle was obtained in 30 (67%) of 44 eligible patients. The mortality rate and duration of ICU stay were not significantly lower in the 24-hour compliant as compared with the noncompliant group (23% vs 33% and 6 [4-11] vs 9 [6-25] days, respectively; P value is not significant). Patients who complied with the 24-hour sepsis bundle after only 12 hours had a lower mortality rate (10% vs 39%, P = .036) and shorter stay (6 [4-10] vs 9 [6-25] days, P = .055) than those who were compliant after 24 hours.
  
  
  CONCLUSIONS
  Correct application of the sepsis bundles was associated with reduced mortality and length of ICU stay. Earlier implementation of the 24-hour management bundle could result in better outcomes.
authors.affiliation: Department of Anesthesiology and Intensive Care, Cattinara Hospital, University of Trieste, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Zambon
authors.forename: Marcello
authors.initials: M
authors.lastname: Ceola
authors.forename: Roberto
authors.initials: R
authors.lastname: Almeida-de-Castro
authors.forename: Antonino
authors.initials: A
authors.lastname: Gullo
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D000368:Aged; D002985:Clinical Protocols; D005240:Feasibility Studies; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D011446:Prospective Studies; D018805:Sepsis / Q000628:therapy*; D012772:Shock, Septic / Q000628:therapy; D013997:Time Factors