Observational Study on the Compliance of 3-Hour Bundle Therapy in Emergency Patients with Septic Shock

XU Meilian

doi:10.13919/j.issn.2095-6274.ZHJY202409015

Abstract：Objective To analyze the implementation of the 3-hour bundle therapy strategy in emergency patients with septic shock at our hospital. Methods A total of 100 patients with septic shock admitted to the Intensive Care Unit of Longyan First Hospital from March 2023 to March 2024 were selected for this study. We analyzed the patients' age,gender,APACHE Ⅱ scores,the clinical implementation of the 3-hour bundle therapy strategy,including central venous pressure (CVP),mean arterial pressure (MAP),urine output,central venous oxy-gen saturation (ScvO2),and mixed venous oxygen saturation (SvO2) levels,the timing of antibiotic administration,the achievement of early goal-directed therapy targets,and the impact of the 3-hour bundle therapy on the 28-day mortality rate. Results Within the first 3 hours,the implementation rate of antibiotic therapy was 100％ (100/100),blood lactate measurement was 94.00％ (94/100),and vasopressor therapy was 92.00％ (92/100),all with compliance rates exceeding 90％,indicating good adherence. The implementation rate of pathogen culture was 70.00％ (70/100),early goal-directed therapy within 3 hours was 53.00％ (53/100),and the overall 3-hour bundle therapy implementation rate was 32.00％ (32/100),all with compliance rates below 80％,indicating lower adherence. The target achievement rates were as follows:CVP at 79.00％,SvO2 and ScvO2 at 56.00％,urine output at 62.00％,and MAP at 58.00％. The overall target achievement rate was 53.00％. In the complete bundle therapy group,2 patients died within 28 days,with a mortality rate of 6.25％,while in the incomplete bundle therapy group,18 patients died within 28 days,with a mortality rate of 26.47％. The mortality rate in the complete bundle thera-py group was significantly lower than that in the incomplete bundle therapy group (P=0.018). Conclusion The 3-hour bundle therapy can reduce the 28-day mortality rate of patients with septic shock,improve the adherence of medical staff to the implementation of bundle therapy,and increase the achievement rate of early goal-direct-ed therapy within 3 hours.