{"id":13672,"date":"2021-05-20T04:08:11","date_gmt":"2021-05-20T02:08:11","guid":{"rendered":"http:\/\/news-papers.eu\/?p=13672"},"modified":"2021-05-09T20:38:46","modified_gmt":"2021-05-09T18:38:46","slug":"13672","status":"publish","type":"post","link":"http:\/\/news-papers.eu\/?p=13672","title":{"rendered":"1-Stunden-Sepsis-B\u00fcndel der SSC: Wirklich immer Blutkulturen?"},"content":{"rendered":"<p style=\"text-align: justify\"><img data-recalc-dims=\"1\" loading=\"lazy\" decoding=\"async\" data-attachment-id=\"555\" data-permalink=\"http:\/\/news-papers.eu\/?attachment_id=555\" data-orig-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1632%2C1224\" data-orig-size=\"1632,1224\" data-comments-opened=\"1\" data-image-meta=\"{&quot;aperture&quot;:&quot;2.4&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;iPhone 5&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;1442910498&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;4.12&quot;,&quot;iso&quot;:&quot;50&quot;,&quot;shutter_speed&quot;:&quot;0.033333333333333&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;1&quot;}\" data-image-title=\"Blutkulturflaschen\" data-image-description=\"\" data-image-caption=\"\" data-medium-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=300%2C225\" data-large-file=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1024%2C768\" class=\"size-medium wp-image-555 alignright\" src=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?resize=300%2C225\" alt=\"\" width=\"300\" height=\"225\" srcset=\"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?resize=300%2C225 300w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?resize=768%2C576 768w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?resize=1024%2C768 1024w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?resize=750%2C563 750w, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?w=1632 1632w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/>Die <strong>Surviving Sepsis Campaign<\/strong>\u00a0(SSC) empfehlen die Verwendung eines <strong>1-h-Sepsis-B\u00fcndels<\/strong>, aber es fehlen klinische Daten, die diese Strategie unterst\u00fctzen.<\/p>\n<div class=\"page\" title=\"Page 1\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<div class=\"page\" title=\"Page 1\">\n<div class=\"layoutArea\">\n<div class=\"column\">\n<p style=\"text-align: justify\"><strong>Zitek T, et al. BLOOD CULTURE RESULTS AND OVERTREATMENT ASSOCIATED WITH THE USE OF A 1-HOUR SEPSIS BUNDLE. The Journal of Emergency Medicine, Vol. 59, No. 5, pp. 629\u2013636, 2020<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<p><strong>Methoden:<\/strong><\/p>\n<ul>\n<li>retrospektive Analyse,<\/li>\n<li>Sepsispatienten aus drei Notaufnahmen,<\/li>\n<li>Rate der wahr-positiven Blutkulturen,<\/li>\n<li>logistische Regressionsanalyse<\/li>\n<\/ul>\n<p><strong>Ergebnisse:<\/strong><\/p>\n<ul>\n<li>n=544 mit vermuteter Sepsis<\/li>\n<li>davon 33,8 % (95 % Konfidenzintervall [CI]: 29,9-38,0%) letztendlich mit einer Sepsis<\/li>\n<li>und 54,6 % (95 % CI_ 50,3-58,8 %) wiesen eine bakterielle Infektion auf<\/li>\n<li>insgesamt waren 7,0 % (95 % CI: 5,0-9,5 %) der Blutkulturen positiv<\/li>\n<li>In der multivariaten logistischen Regressionsanalyse waren folgende Konstellationen mit positiven Blutkulturen assoziiert:\n<ul>\n<li>Temperatur &gt;38 C oder &lt; 36 C<\/li>\n<li>Laktat &gt;4 mmol\/L<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Warum ist dieses Thema wichtig?<\/strong><br \/>\nDie SSC empfehlen die Verwendung eines 1-Stunden-Sepsis-B\u00fcndels zur Beschleunigung der Versorgung von kritisch kranken septischen Patienten. Die Verwendung eines 1-Stunden-Sepsis-B\u00fcndels k\u00f6nnte jedoch mit der unn\u00f6tigen Anordnung von Blutkulturen und dem \u00fcberm\u00e4\u00dfigen Einsatz von Antibiotika verbunden sein.<\/p>\n<p><strong>2. Was versucht diese Studie zu zeigen?<\/strong><br \/>\nIn dieser Studie wurde versucht, die Rate zu bestimmen, mit der Patienten, die sich einem 1-Stunden-Sepsis-Protokoll unterziehen, eine Bakteri\u00e4mie aufweisen. Es wurde auch versucht, die Raten zu bestimmen, mit denen bei diesen Patienten letztendlich eine Sepsis oder eine bakterielle Infektion diagnostiziert wird.<\/p>\n<p><strong>3. Was sind die wichtigsten Ergebnisse?<\/strong><br \/>\nWenn bei Patienten, die einem 1-Stunden-Sepsis-Protokoll unterzogen werden, Blutkulturen durchgef\u00fchrt werden, ist die Ausbeute gering. Bei den meisten Patienten, die sich einem 1-Stunden-Sepsis-Protokoll unterziehen, wird letztendlich keine Sepsis diagnostiziert, und etwa die H\u00e4lfte hat keine bakterielle Infektion.<\/p>\n<p style=\"text-align: justify\"><strong>4. Wie wird die Patientenversorgung beeinflusst?<\/strong><br \/>\nEin gezielterer Ansatz f\u00fcr den Einsatz von Blutkulturen bei Patienten mit m\u00f6glicher Sepsis k\u00f6nnte zu erheblichen Kosteneinsparungen f\u00fchren und den Patienten die Sch\u00e4den durch falsch-positive Ergebnisse ersparen. Im Allgemeinen sollte die Verwendung eines 1-Stunden-Sepsis-B\u00fcndels vor einer breiten Einf\u00fchrung genauer untersucht werden.<\/p>\n<p style=\"text-align: justify\">Anders als die Autoren sehen wir von <a href=\"http:\/\/www.news-papers.eu\" target=\"_blank\" rel=\"noopener\"><strong>news-papers.eu<\/strong><\/a> es etwa anders: Die Diskriminierung von Sepsis vs. keine Sepsis ist h\u00e4ufig erst im innenklinischen station\u00e4ren Verlauf m\u00f6glich. Keine Abnahme vor Gabe einer antiinfektiven Therapie kann massgeblich die Versorgung verschlechtern. Also stellt sich die Frage: ist es schlechter &#8222;manche&#8220; Patienten zu \u00fcbersehen oder bei &#8222;manchen&#8220; zu viel Blutkulturen abzunehmen? \u00d6konomische Gedanken sind sicherlich gut, aber auch nicht jede negative Blutkultur bedeutet einen Sepsis-negativen Patient. Wir halten uns daher weiterhin an die Vorgaben des SSC: Ja bei V.a. Sepsis immer Blutkulturen und auch unabh\u00e4ngig von Laktat und Temperatur.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Die Surviving Sepsis Campaign\u00a0(SSC) empfehlen die Verwendung eines 1-h-Sepsis-B\u00fcndels, aber es fehlen klinische Daten, die diese Strategie unterst\u00fctzen. Zitek T, et al. BLOOD CULTURE RESULTS AND OVERTREATMENT ASSOCIATED WITH THE [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":555,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"__cvm_playback_settings":[],"__cvm_video_id":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[57],"tags":[157,78,67],"class_list":["post-13672","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sepsis","tag-blutkultur","tag-notaufnahme","tag-sepsis"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1632%2C1224","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/s7fR2g-13672","jetpack-related-posts":[{"id":9331,"url":"http:\/\/news-papers.eu\/?p=9331","url_meta":{"origin":13672,"position":0},"title":"Kennen Sie das &#8222;1 h-Sepsis Bundle&#8220; der SSC?","author":"Michael Bernhard","date":"Mai 22, 2019","format":false,"excerpt":"Bisher hatten wir das 3 h und das 6 h Bundle f\u00fcr die Sepsistherapie, seit letztem Jahr gibt es das zusammenfasste 1 h Sepsis-Bundle der Surviving Sepsis Campaign (SSC). Levy MM, et al. The surviving\u00a0sepsis campaign bundle: 2018 update. Intensive\u00a0CareMed 2018; 44:925\u2013928 Kennen Sie eigentlich das 1 h Bundle ?\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"http:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=700%2C400 2x"},"classes":[]},{"id":3737,"url":"http:\/\/news-papers.eu\/?p=3737","url_meta":{"origin":13672,"position":1},"title":"Surviving Sepsis Campaign 2017 &#8211; Teil 1","author":"Michael Bernhard","date":"April 11, 2017","format":false,"excerpt":"Die 2016er\u00a0\"Surviving Sepsis Campaign\" Empfehlungen zur Behandlung der Sepsis sind publiziert worden: Rhodes A et al.,\u00a0Surviving Sepsis Campaign: International\u00a0Guidelines for Management of Sepsis and Septic\u00a0Shock: 2016. Crit Care Med 2017;\u00a0DOI: 10.1097\/CCM.0000000000002255 (PDF) oder Rhodes A et al.,\u00a0Surviving Sepsis Campaign: International\u00a0Guidelines for Management of Sepsis and Septic\u00a0Shock: 2016. Intensive\u00a0Care Med 2017;\u00a0DOI\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"http:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/01\/Bildschirmfoto-2017-01-23-um-07.57.24-e1485154716876.png?fit=500%2C343&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":3747,"url":"http:\/\/news-papers.eu\/?p=3747","url_meta":{"origin":13672,"position":2},"title":"Surviving Sepsis Campaign &#8211; Guidelines 2017 &#8211; 4th Edition","author":"Michael Bernhard","date":"Januar 25, 2017","format":false,"excerpt":"Gerade sind die neuen Surviving Sepsis Campaign Guidelines 2017\u00a0erschienen: Gesamte Leitlinie\u00a0(67 Seiten, 655 Literaturstellen):\u00a0 Rhodes A et al.,\u00a0Surviving Sepsis Campaign: International\u00a0Guidelines for Management of Sepsis and Septic\u00a0Shock: 2016. Crit Care Med 2017;\u00a0DOI: 10.1097\/CCM.0000000000002255 (PDF) User\u00b4s Guideline\u00a0(5 Seiten): Dellinger RP, et al. A Users\u2019 Guide to the 2016 Surviving Sepsis\u00a0Guidelines. Crit\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"http:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2017\/01\/Bildschirmfoto-2017-01-23-um-07.57.24-e1485154716876.png?fit=500%2C343&resize=350%2C200","width":350,"height":200},"classes":[]},{"id":15324,"url":"http:\/\/news-papers.eu\/?p=15324","url_meta":{"origin":13672,"position":3},"title":"Neue internationale Sepsis-Leitlinien 2021 &#8211; Eine Zusammenfassung","author":"Michael Bernhard","date":"April 7, 2022","format":false,"excerpt":"In der Fachzeitschrift An\u00e4sthesiologie & Intensivmedizin gibt es im OPEN ACCESS Format immer wieder sehr lesenswerte Artikel. Hier ein Artikel zum Update der Surviving Sepsis Campaign aus dem Oktober\u00a02021 zur Behandlung von Sepsis und septischem Schock. Der vorliegende Artikel fasst die wichtigsten Vera\u0308nderungen zusammen und stellt sie der Vorga\u0308ngerversion der\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"http:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Blutkulturflaschen.jpg?fit=1200%2C900&resize=1050%2C600 3x"},"classes":[]},{"id":2871,"url":"http:\/\/news-papers.eu\/?p=2871","url_meta":{"origin":13672,"position":4},"title":"Sieht aus wie Sepsis &#8211; Ist aber keine Sepsis &#8230;","author":"Michael Bernhard","date":"Januar 15, 2017","format":false,"excerpt":"Sepsis Mimics:\u00a0Sieht aus wie Sepsis - Ist aber keine Sepsis ... Brit Long und Kollegen haben im Journal of Emergency Medicine einen exzellenten Artikel zu dieser Thematik publiziert: Long B et al., Clinical mimics: An emergency medicine-focused review of sepsis mimics. JEM 2016,\u00a0http:\/\/dx.doi.org\/10.1016\/j.jemermed.2016.07.102 In diesem Artikel stellt Brit Long ein\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"http:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2016\/02\/Sepsis.jpg?fit=900%2C1200&resize=700%2C400 2x"},"classes":[]},{"id":14409,"url":"http:\/\/news-papers.eu\/?p=14409","url_meta":{"origin":13672,"position":5},"title":"Neue &#8222;Surviving Sepsis Campaign&#8220; Guideline 2021: Kernaussagen Teil 1","author":"Michael Bernhard","date":"Oktober 5, 2021","format":false,"excerpt":"Die neue Surviving Sepsis Campaign Guideline 2021 ist am 02.10.2021 publiziert worden: Evans L, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. This article is co\u2010published in the journals Intensive Care Medicine (https:\/\/doi.org\/10.1007\/s00134\u2010021\u201006506\u2010y) and Critical Care Medicine (https:\/\/doi.org\/10.1097\/CCM.0000000000005337). (PDF) Hier ganz frisch einige\u2026","rel":"","context":"In &quot;Sepsis&quot;","block_context":{"text":"Sepsis","link":"http:\/\/news-papers.eu\/?cat=57"},"img":{"alt_text":"Sepsis","src":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&resize=350%2C200 1x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&resize=700%2C400 2x, https:\/\/i0.wp.com\/news-papers.eu\/wp-content\/uploads\/2021\/10\/Bildschirmfoto-2021-10-04-um-21.41.56.png?fit=1200%2C1148&resize=1050%2C600 3x"},"classes":[]}],"jetpack_likes_enabled":true,"_links":{"self":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/13672","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=13672"}],"version-history":[{"count":5,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/13672\/revisions"}],"predecessor-version":[{"id":13677,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/posts\/13672\/revisions\/13677"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=\/wp\/v2\/media\/555"}],"wp:attachment":[{"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=13672"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=13672"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/news-papers.eu\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=13672"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}