WHAT’S NEW? SEP-1 Measures are Now Public on CMS Hospital Compare
The new SEP-1 guidelines became effective on July 1 2018, and your hospital can now meet the 6-hour bundle by demonstrating that ONE of the following was measured or performed:
– Central Venous Oxygen Saturation
– Fluid Challenge or Passive Leg Raise
SEP-1 V5.4 UPDATE (JULY 2018)
Why are Sepsis and Septic Shock Patients Likely to Benefit From Cheetah Technology?
Cheetah systems have two dynamic assessment protocols available to clinicians, Fluid Bolus and Passive Leg Raise (PLR). Cheetah along with a fluid challenge or passive leg raise can now meet the repeat volume assessment portion of the 6-hour bundle, with no additional requirement. Since Cheetah systems are 100% noninvasive they can be deployed during any stage of the bundle.
Dynamic assessments provide more reliable indicators for appropriate fluid management by measuring changes in SVI and accurately assessing the response to a fluid bolus challenge or passive leg raise (PLR) maneuver.
SEPSIS AND SEPTIC SHOCK
Sepsis is life-threatening organ dysfunction caused by the body’s aggressive response to severe, blood-borne infection, which can lead to tissue damage, organ failure, and death. Septic shock is a perfusion emergency associated with hypotension and hypoperfusion1,2.
Extensive literature demonstrates the importance of optimal management of IV fluid in septic shock. Clearly in the septic patient population, achieving the proper fluid balance between over and under resuscitation is crucial to avoiding increased morbidity, mortality and cost.
Sepsis Statistics and Trends
- Every year, severe sepsis strikes more than 1.7 million Americans3.
- Severe Sepsis and Septic Shock kills 1 in 3 affected patients4.
- A cornerstone of treating patients with Septic Shock is IV Fluid therapy. However, volume overload in septic patients is associated with an increased risk of mortality5,6.
- The Agency for Healthcare Research and Quality lists sepsis as the most expensive condition treated in US hospitals, costing more than $20 billion in 20117.
- Based on the results of three major clinical studies (ProCESS, ARISE and ProMISE), leading organizations have updated their sepsis management guidelines:
- Surviving Sepsis Campaign8
- CMS / National Quality Forum9
- European Society of Intensive Care Medicine10
1. Al-Khafaji A, Pinsky M, et al. Multiple organ dysfunction in sepsis: Background, Pathophysiology, Epidemiology. http://emedicine.medscape.com/article/169640-overview#a4.
2. Martin G. Sepsis, severe sepsis and septic shock: changes in incidence, pathogens and outcomes. Exp Rev Anti Infec 2012; 10: 701-706.
3. National Center for Health Statistics Data Brief No. 62 June 2011. Inpatient care for septicemia or sepsis: a challenge for patients and hospitals
4. Rhee C et al. Incidence and trends of sepsis in us hospitals using clinical vs claims data, 2009-2014. JAMA 2017;318: 1241-1249.
5. Sirvent et al (2014). Fluid balance in sepsis and septic shock as a determining factor of mortality. American Journal of Emergency Medicine
6. Kelm et al (2015)- Fluid overload in patients with severe sepsis and septic shock treated with early goal directed therapy is associated with increased acute need for fluid-related medical interventions and hospital death. Shock 42;68073
7. Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project Statistical Brief No. 160 August 2013. National inpatient hospital costs: the most expensive conditions by payer, 2011
10. Cecconi M, Backer DD, et al. Consensus on circulatory shock and hemodynamic monitoring. Task force of the European Society of Intensive Care Medicine. 2014; 40(12)1795-815.