Introduction

Treatment of severe sepsis with infusion of activated protein C (APC) (Xigris) in the ICU of Barlicki University Hospital was initiated in 2003. From 2003 the number of treated patients increased significantly. This is due to better recognition. The introduced program consists of education of working staff in all hospitals in the region. Barlicki Hospital is a reference hospital for treatment of sepsis, and patients with diagnosis of sepsis are transferred to this ICU. University ICU doctors are teaching workshops how to recognize and treat sepsis.

Methods

The surviving ratio in patients treated with APC was estimated retrospectively. Analysis included the years from 2003 to 10 December 2006.

Results

A total number of 61 patients, aged 18–65 years, were included in the analysis. The pathogens and infection location were different. Patients were diagnosed according to recommendations of the Polish Sepsis Group and treatment with APC was introduced. The increase in number was: in 2004 vs 2003, 200%; in 2005 vs 2004, 111%; in 2006 up to 10 December vs 2005, 57.8%. The surviving ratio increased every year but in 2006 it decreased compared with 2005.

Discussion

During 4 years of treatment of severe sepsis in the ICU with APC, important changes were observed: faster recognition and diagnosis, transfer to the reference hospital, and introduction of adequate therapy. The decrease in the surviving ratio in 2006 is probably due to a more serious state of the admitted patients – more initial infection located in the abdomen after surgery.

Conclusion

The education program is essential in increasing the number of fast recognitions, which influences the surviving ratio.

Table 1 abstract P57
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