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Cited by 279

The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.

Bundled care for septic shock: An analysis of clinical trials*

Open access
Barochia, Amisha V., Cui, Xizhong, Vitberg, David, Suffredini, Anthony F., OʼGrady, Naomi P., Banks, Steven M., Minneci, Peter, Kern, Steven J., Danner, Robert L., Natanson, Charles, Eichacker, Peter Q.·2010·Critical Care Medicine
DOI 10.1097/ccm.0b013e3181cb0ddf
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Abstract

CONTEXT: Sepsis bundles have been developed to improve patient outcomes by combining component therapies. Valid bundles require effective components with additive benefits. Proponents encourage evaluation of bundles, both as a whole and based on the performance of each component. OBJECTIVE: Assess the association between outcome and the utilization of component therapies in studies of sepsis bundles. DATA SOURCE: Database searches (January 1980 to July 2008) of PubMed, Embase, and the Cochrane Library, using the terms sepsis, bundles, guidelines, and early goal directed therapy. DATA EXTRACTION: Inclusion required comparison of septic adults who received bundled care vs. nonprotocolized care. Survival and use rates for individual interventions were abstracted. MAIN RESULTS: Eight unblinded trials, one randomized and seven with historical controls, were identified. Sepsis bundles were associated with a consistent (I2 = 0%, p = .87) and significant increase in survival (odds ratio, 1.91; 95% confidence interval, 1.49-2.45; p < .0001). For all studies reporting such data, there were consistent (I2 = 0%, p > or = .64) decreases in time to antibiotics, and increases in the appropriateness of antibiotics (p < or = .0002 for both). In contrast, significant heterogeneity was seen across trials for all other treatments (antibiotic use within a specified time period; administration of fluids, vasopressors, inotropes, and packed red blood cells titrated to hemodynamic goals; corticosteroids and human recombinant activated protein C use) (all I2 > or = 67%, p < .002). Except for antibiotics, sepsis bundle components are still being investigated for efficacy in randomized controlled trials. CONCLUSION: Bundle use was associated with consistent and significant improvement in survival and antibiotic use. Use of other bundle components changed heterogeneously across studies, making their impact on survival uncertain. However, this analysis should be interpreted cautiously as these studies were unblinded, and only one was randomized.

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Metadata

Authors
Barochia, A. V., Cui, X., Vitberg, D., Suffredini, A. F., OʼGrady, N. P., Banks, S. M., Minneci, P., Kern, S. J., Danner, R. L., Natanson, C., & Eichacker, P. Q.
Venue
Critical Care Medicine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-02
Volume
38
Issue
2
Pages
668-678
ISSN
0090-3493 (ISSN-L)
DOI
10.1097/ccm.0b013e3181cb0ddf
OpenAlex
W1987631503
Cited by
279
References
9
FWCI
19.50
Type
journal article
Language
en
Open access
green

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CoChat. (2026). Citation check: Bundled care for septic shock: An analysis of clinical trials*. https://app.cochat.ai/papers/10.1097/ccm.0b013e3181cb0ddf
The paper
Barochia, A. V., Cui, X., Vitberg, D., Suffredini, A. F., OʼGrady, N. P., Banks, S. M., Minneci, P., Kern, S. J., Danner, R. L., Natanson, C., & Eichacker, P. Q. (2010). Bundled care for septic shock: An analysis of clinical trials*. Critical Care Medicine. https://doi.org/10.1097/ccm.0b013e3181cb0ddf

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.