Implementation of Sepsis Bundles in Intensive Care Units of Bangladesh: A Prospective Observational Study

  • Mohammad Omar Faruq Professor, Department of Critical Care Medicine BIRDEM General Hospital, Shahbag, Dhaka 1000
  • ASM Areef Ahsan Asso. Professor, Department of Critical Care Medicine, BIRDEM General Hospital & Consultant, Intensive Care Unit, Ibn Sina Hospital, Dhanmondi, Dhaka
  • Mirza Nazim Uddin Chief Consultant, Intensive Care Unit, Square Hospital, Panthapath, Dhaka
  • UH Shahera Khatun Professor, Dept. of Anesthesia & ICU, Dhaka Community Medical College & Former Prof of Anesthesia & ICU, Dhaka Medical College Hospital, Dhaka
  • Md Abdul Mannan Professor, Dept. of Anesthesia & Critical Care, Holy Family Red Crescent Medical College & Hospital, Dhaka.
  • Rownak Jahan Tamanna Asst. Professor, Department of Cardiology, BIRDEM General Hospital, & Consultant, Intensive Care Unit, Islami Bank Central Hospital, Kakrail, Dhaka
  • Kaniz Fatema Asst. Professor, Department of Critical Care Medicine, BIRDEM General Hospital & Consultant, Intensive Care Unit, Aysha Memorial Specialized Hospital, Mohakhali, Dhaka.
  • Fatema Ahmed Junior Consultant, Department of Critical Care Medicine, BIRDEM General Hospital & Consultant, Intensive Care Unit, Renaissance Hospital & Research Institute Ltd., Dhanmondi, Dhaka
  • ARM Nooruzzaman Junior Consultant, Department of Critical Care Medicine, BIRDEM General Hospital & Consultant, Intensive Care Unit, Renaissance Hospital & Research Institute Ltd., Dhanmondi, Dhaka
  • Mohammed Maniruzzaman Chief Consultant, Dept. of Critical Care Medicine, United Hospital, Gulshan, Dhaka
  • AKM Shakiqur Rahman Professor, Intensive Care Unit, Metropolitan Medical Center Ltd, Mohakhali, Dhaka
  • AK Qumrul Huda Asso. Professor, Dept. of Anesthesia, Analgesia & Intensive Care Medicine, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka
  • Lutful Aziz Chief Consultant, Intensive Care Unit, The Apollo Hospital, Basundhara, Dhaka
  • Md Sayedul Islam Assoc. Professor, National Institute of Diseases of Chest & Hospital, Mohakhali, & Consultant, Intensive Care Unit, Lab- Aid Specialized Hospital, Dhanmondi, Dhaka
  • Mohammed Faruk Consultant, Intensive Care Unit, Lab-Aid Specialized Hospital, & Ex-Consultant, Intensive Care Unit, Bangladesh Medical College Hospital, Dhanmondi, Dhaka
  • MHM Delwar Hossain Consultant, Dept. of Anesthesia, Combined Military Hospital, Dhaka Cantonment, Dhaka.
  • Raghib Manzoor Consultant, Intensive Care Unit, Central Hospital, Dhanmondi, Dhaka.
  • SM Hossain Shahid Consultant, Intensive Care Unit, Anwer Khan Modern Medical College & Hospital, Dhanmondi, Dhaka.
  • Md Nurul Amin Research Consultant, Ibrahim Cardiac Hospital & Research Institute, Shahbag, Dhaka
Keywords: Severe sepsis, septic shock, Intensive care units, compliance, mortality

Abstract

Objective: To assess compliance of Intensive Care Units (ICUs) of Bangladesh to the components of resuscitation & management bundles of Surviving Sepsis Campaign (SSC). Secondary objective was to assess the impact of compliance on mortality and to determine how its compliance & mortality compared with other Asian and Western countries.

Design: Prospective Cohort study.

Setting: 14 ICUs of Bangladesh.

Participants: 65 adult patients with severe sepsis admitted into these ICUs in July 2009. The organizational characteristics of the participating centers, the patients baseline characteristics, the achievement of target within the resuscitation & management bundle & outcome data were recorded.

Outcome: Compliance with the Surviving Sepsis Campaigns resuscitation (6 hrs) & management (24 hrs) bundles.

Results: Hospital mortality in ICU patients of Bangladesh suffering from severe sepsis was 49·2%. It was significantly higher than countries reported. Compliance to entire components of both resuscitation & management bundles were reported to be zero in ICUs of Bangladesh. Compliance of individual components of the bundles did not predict improved survival.

Conclusion: In ICUs of Bangladesh, high mortality of severe sepsis and failure of compliance of SSC bundle guidelines to have positive impact on survival were presumably attributed to delayed diagnosis, poor adherence to & delayed application of SSC guidelines on sepsis bundles.

DOI: http://dx.doi.org/10.3329/bccj.v1i1.14359

Bangladesh Crit Care J March 2013; 1: 8-17

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Abstract
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Published
2013-03-30
How to Cite
Faruq, M., Ahsan, A., Uddin, M., Khatun, U., Mannan, M. A., Tamanna, R., Fatema, K., Ahmed, F., Nooruzzaman, A., Maniruzzaman, M., Rahman, A., Huda, A., Aziz, L., Islam, M. S., Faruk, M., Hossain, M., Manzoor, R., Shahid, S., & Amin, M. N. (2013). Implementation of Sepsis Bundles in Intensive Care Units of Bangladesh: A Prospective Observational Study. Bangladesh Critical Care Journal, 1(1), 8-17. https://doi.org/10.3329/bccj.v1i1.14359
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Original Articles