Journal of Hebei Medical University ›› 2021, Vol. 42 ›› Issue (9): 1042-1045,1088.doi: 10.3969/j.issn.1007-3205.2021.09.010

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Clinical decision support system helps to improve the compliance of bundle therapy for septic shock

  

  1. Department of Intensive Care Unit, Hebei General Hospital, Shijiazhuang 050051, China
  • Online:2021-09-25 Published:2021-09-28

Abstract: Objective To improve the compliance and implementation rate of bundle therapy for septic shock. 
Methods A total of 144 patients with septic shock were randomly divided into control group and experimental group. The control group completed the established bundle treatment measures within 1 h, 3 h and 6 h after the diagnosis of septic shock according to the guidelines. The experimental group used the septic shock quality control module of intelligent clinical decision support system for severe diseases to establish the bundle treatment path process within 1 h, 3 h and 6 h after the diagnosis of septic shock. The system timely and repeatedly reminded the medical staff in each specific time period until the indicators of septic shock bundle treatment measures were completed. The effects of bundle therapy were compared between two groups, including 1 h, 3 h and 6 h target completion rate, mean arterial pressure(MAP), central venous pressure(CVP), central venous oxygen saturation(ScvO2), 6-hour lactate clearance rate(LCR), urine volume, norepinephrine dose and outcome indicators. 
Results The target completion rates of 1 h, 3 h and 6 h in the experimental group were higher than those in the control group(P<0.05). There was no significant difference in MAP, CVP and urine volume between two groups(P>0.05). ScvO2 and 6 h LCR in the experimental group were lower than those in the control group, while norepinephrine dose was higher than that in the control group(P<0.05), and the length of ICU stay in the experimental group was shorter than that in the control group(P<0.05). There was no significant difference in 28-day mortality between two groups(P>0.05). 
Conclusion Intelligent clinical decision support system for severe diseases can timely warn and diagnose septic shock through data collection and analysis. Timely and repeated reminders within a specific period of time can promote the effective implementation of various projects of septic shock bundle therapy, significantly improve the therapeutic effect in the treatment of patients with septic shock, and improve the treatment efficiency of septic shock and the quality of medical care. 


Key words: shock, septic, intelligent clinical decision support system for severe diseases, bundle therapy