ArticleAmerican journal of respiratory and critical care medicine2016
Multicenter Implementation of a Treatment Bundle for Patients with Sepsis and Intermediate Lactate Values.
Article in American journal of respiratory and critical care medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04143035 (Hemodynamic Resuscitation and Monitoring in Early Sepsis), which is not on this map. Cited by 62 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Hemodynamic Resuscitation and Monitoring in Early Sepsis
Who cites it
62 citing papers in PubMed, 4 syntheses or guidelines pooled it, 131 citations in OpenAlex.
- Restrictive resuscitation in patients with sepsis and mortality: A systematic review and meta-analysis with trial sequential analysis.Pharmacotherapy · 2023Pooled it
- Learning health systems using data to drive healthcare improvement and impact: a systematic review.BMC health services research · 2021Pooled it
- Antibiotic- and Fluid-Focused Bundles Potentially Improve Sepsis Management, but High-Quality Evidence Is Lacking for the Specificity Required in the Centers for Medicare and Medicaid Service's Sepsis Bundle (SEP-1).Critical care medicine · 2019Pooled it
- Evidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1): A Systematic Review.Annals of internal medicine · 2018Pooled it
- Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study.Critical care (London, England) · 2018Trial
- Comorbidities, Weight-Based Initial Fluid Resuscitation, and Mortality in Patients With Sepsis.JAMA network open · 2026Article
- Clinical Outcomes for Emergency Department Presentations of Sepsis Managed on a Clinical Pathway: A Systematic Review and Meta-Analysis.Healthcare (Basel, Switzerland) · 2026Review
- Hematological parameter dynamics in critically ill patients treated with oXirisBMC nephrology · 2026Observational
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- Distinct 72-hour fluid balance trajectories are associated with 28-day mortality in a multicenter cohort of sepsis patients.Scientific reports · 2026Observational
- Efficacy of thiamine (vitamin B1) in sepsis and septic shock: A meta-analysis of randomized controlled trials.Clinics (Sao Paulo, Brazil) · 2026Review
- Complex Sepsis Presentations, SEP-1 Compliance, and Outcomes.JAMA network open · 2025Article
- Distinct immunological signatures define three sepsis recovery trajectories: a multi-cohort machine learning study.Frontiers in medicine · 2025Article
- Understanding How Clinicians Personalize Fluid and Vasopressor Decisions in Early Sepsis Management.JAMA network open · 2024Article
- A biomarker panel of C-reactive protein, procalcitonin and serum amyloid A is a predictor of sepsis in severe trauma patients.Scientific reports · 2024Observational
- What is new and different in the 2021 Surviving Sepsis Campaign guidelines.Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2023Review
- Precision fluid and vasoactive drug therapy for critically ill patients.Pharmacotherapy · 2023Review
- Impact of a cumulative positive fluid balance during the first three ICU days in patients with sepsis: a propensity score-matched cohort study.Annals of intensive care · 2023Article
- Evolving Management Practices for Early Sepsis-induced Hypoperfusion: A Narrative Review.American journal of respiratory and critical care medicine · 2023Review
- Chinese experts' consensus on the application of intensive care big data.Frontiers in medicine · 2023Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
rationaleTreatments for patients with sepsis with intermediate lactate values (≥2 and <4 mmol/L) are poorly defined.
objectivesTo evaluate multicenter implementation of a treatment bundle (including timed intervals for antibiotics, repeat lactate testing, and intravenous fluids) for hemodynamically stable patients with sepsis and intermediate lactate values in the emergency department.
methodsWe evaluated patients in annual intervals before and after bundle implementation in March 2013. We evaluated bundle compliance and compared outcome measures across groups with multivariable logistic regression. Because of their perceived risk for iatrogenic fluid overload, we also evaluated patients with a history of heart failure and/or chronic kidney disease. MEASUREMENTS AND MAIN
resultsWe identified 18,122 patients with sepsis and intermediate lactate values, including 36.1% treated after implementation. Full bundle compliance increased from 32.2% in 2011 to 44.9% after bundle implementation (P < 0.01). Hospital mortality was 8.8% in 2011, 9.3% in 2012, and 7.9% in 2013 (P = 0.02). Treatment after bundle implementation was associated with an adjusted hospital mortality odds ratio of 0.81 (95% confidence interval, 0.66-0.99; P = 0.04). Decreased hospital mortality was observed primarily in patients with a heart failure and/or kidney disease history (P < 0.01) compared with patients without this history (P > 0.40). This corresponded to notable changes in the volume of fluid resuscitation in patients with heart failure and/or kidney disease after implementation.
conclusionsMulticenter implementation of a treatment bundle for patients with sepsis and intermediate lactate values improved bundle compliance and was associated with decreased hospital mortality. These decreases were mediated by improved mortality and increased fluid administration among patients with a history of heart failure and/or chronic kidney disease.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.