<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0873-3015</journal-id>
<journal-title><![CDATA[Millenium - Journal of Education, Technologies, and Health]]></journal-title>
<abbrev-journal-title><![CDATA[Mill]]></abbrev-journal-title>
<issn>0873-3015</issn>
<publisher>
<publisher-name><![CDATA[Instituto Politécnico de Viseu (IPV)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0873-30152021000400091</article-id>
<article-id pub-id-type="doi">10.29352/mill029e.25020</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Protocolos de atuação na abordagem ao doente com sépsis em contexto de urgência: uma revisão sistemática com meta-análise]]></article-title>
<article-title xml:lang="en"><![CDATA[Performance protocols in the approach to the patient with sepsis in the emergency department: a systematic review with meta-analysis]]></article-title>
<article-title xml:lang="es"><![CDATA[Protocolos de actuación en el abordaje de pacientes con sepsis en urgencias: una revisión sistemática con meta-análisis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dias]]></surname>
<given-names><![CDATA[António Madureira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar e Universitário de Coimbra Serviço de Urgência ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Polytechnic Institute of Viseu Health School ]]></institution>
<addr-line><![CDATA[Viseu ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Nursing School of Coimbra Health Sciences Research Unit: Nursing (UICISA:E) ]]></institution>
<addr-line><![CDATA[Coimbra ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2021</year>
</pub-date>
<numero>esp9</numero>
<fpage>91</fpage>
<lpage>99</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0873-30152021000400091&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0873-30152021000400091&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0873-30152021000400091&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução: A sépsis constitui um grande problema de saúde afetando milhões de pessoas anualmente sendo emergente a sua identificação precoce e o tratamento apropriado nas primeiras horas. A implementação de protocolos de atuação pode melhorar os resultados, contudo este é ainda um assunto em debate.  Objetivo: Descrever o impacto da utilização de protocolos de atuação em serviços de urgência na abordagem ao doente com sépsis em relação à redução do tempo até à toma do primeiro antibiótico e mortalidade.  Métodos: Foi realizada uma revisão sistemática com meta-análise segundo a metodologia proposta pela Joanna Briggs Institute. Dois revisores independentes realizam a avaliação crítica, extração e síntese dos dados.  Resultados:  Foram incluídos sete estudos. Os resultados da meta-análise mostraram não existir diferenças na taxa mortalidade (todo o tempo hospitalar) (RR=0,84, IC95%=0,63-1,14, p=0,27). Contudo, para a mortalidade a 30 dias existem diferenças significativas que favorecem o grupo que utilizou protocolos na abordagem ao doente com sépsis (RR=0,80, IC95%=0,68-0,95, p=0,01) e uma redução do tempo para antibióticos (MD=-41,83, IC95%=-77,89- -5,77, p=0,02).  Conclusão:  Os protocolos de atuação em serviços de urgência na abordagem ao doente com sépsis reduzem a mortalidade e o tempo até à toma do primeiro antibiótico. Nesse sentido, a sua implicação impõe-se como essencial para melhoria dos resultados em saúde.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Sepsis has become a major health problem affecting millions of people annually, and its early identification and appropriate treatment in the first hours is emergent. The implementation of protocols can improve outcomes, however this is still a subject under debate.  Objetive: To describe the impact of the use of protocols in emergency departments on the approach to patients with sepsis in order to reduce time to the first antibiotic and mortality.  Methods: A systematic review with meta-analysis was conducted following the methodology proposed by the Joanna Briggs Institute. Two independent reviewers performed the critical appraisal, extraction and synthesis of data.  Results: Seven studies were included. The results of the meta-analysis showed no differences in the mortality rate (all hospital time) (RR=0.84, 95%CI=0.63-1.14, p=0.27). However, for 30-day mortality there are significant differences favouring the group that used protocols in the approach to the sepsis patient (RR=0.80, 95%CI=0.68-0.95, p=0.01) and a reduction of time to antibiotics (MD=-41.83, 95%CI=-77.89- -5.77, p=0.02).  Conclusion:  Emergency department protocols reduce mortality and the time until the first antibiotic is taken. Therefore, their implementation is essential to improve health outcomes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  La septicemia constituye un gran problema de salud que afecta a millones de personas anualmente, siendo emergente su identificación temprana y el tratamiento adecuado en las primeras horas. La aplicación de protocolos puede mejorar los resultados, pero esto sigue siendo un tema de debate.  Objetivo:  Describir el impacto del uso de protocolos en los servicios de urgencias en el abordaje de los pacientes con sepsis en cuanto a la reducción del tiempo hasta el primer antibiótico y la mortalidad.  Métodos:  Se realizó una revisión sistemática con metaanálisis siguiendo la metodología propuesta por el Instituto Joanna Briggs. Dos revisores independientes realizaron la evaluación crítica, la extracción y la síntesis de los datos.  Resultados:  Se incluyeron siete estudios. Los resultados del metaanálisis no mostraron diferencias en la tasa de mortalidad (todo el tiempo de hospitalización) (RR=0,84, IC95%=0,63-1,14, p=0,27). Sin embargo, para la mortalidad a 30 días hay diferencias significativas que favorecen al grupo que utilizó los protocolos en el abordaje del paciente con sepsis (RR=0,80, IC95%=0,68-0,95, p=0,01) y una reducción del tiempo a los antibióticos (DM=-41,83, IC95%=-77,89- -5,77, p=0,02).  Conclusión:  Los protocolos de actuación en servicios de urgencia en el abordaje del paciente con sepsis reducen la mortalidad y el tiempo hasta la toma del primer antibiótico. Por lo tanto, su aplicación es esencial para mejorar los resultados de salud.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[sepse]]></kwd>
<kwd lng="pt"><![CDATA[choque séptico]]></kwd>
<kwd lng="pt"><![CDATA[antibioticoprofilaxia]]></kwd>
<kwd lng="pt"><![CDATA[mortalidade]]></kwd>
<kwd lng="pt"><![CDATA[protocolos clínicos]]></kwd>
<kwd lng="en"><![CDATA[sepsis]]></kwd>
<kwd lng="en"><![CDATA[shock, septic]]></kwd>
<kwd lng="en"><![CDATA[antibiotic prophylaxis]]></kwd>
<kwd lng="en"><![CDATA[mortality]]></kwd>
<kwd lng="en"><![CDATA[clinical protocols]]></kwd>
<kwd lng="es"><![CDATA[sepsis]]></kwd>
<kwd lng="es"><![CDATA[choque séptico]]></kwd>
<kwd lng="es"><![CDATA[profilaxis antibiótica]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[protocolos clínicos]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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