Use of the FAST HUG checklist in Mexican critically ill patients

Introduction

There have been several efforts to improve the quality of care of ICU patients. The use of checklists has been linked to improvements in ICU care. In 2005, Vincent and colleagues published the FAST HUG checklist strategy [1]. We decided to study the level of adherence of Mexican physicians to the measures proposed in this checklist.

Methods

We conducted a 3-month prospective observational study in the adult ICU of an academic hospital in northeastern Mexico. Patients were sorted into one of the two study groups: group 1 had a critical care physician on charge of the ICU management, while group 2 had a non-critical care physician on charge. We measured the adherence of the physicians to the FAST HUG checklist items. We arbitrarily defined good compliance as having fulfilled >4 items.

Results

One hundred and forty-seven patients were admitted to the ICU during the study period, but only 129 had complete data and were evaluated. There were 86 patients in group 1, while group 2 had 43 patients. Group 1 patients had higher age, SOFA and APACHE score on admission. We analyzed the subgroup of patients who had an initial APACHE score between 11 and 25, as they are usually the ones most likely to benefit from FAST HUG measures. These results are described in Table 1. We noticed that most of the group 1 patients had severe sepsis, while most of the group 2 patients had ischemic heart disease, which clearly explains the differences in mechanical ventilation and length of ICU stay.

Table 1 Variables of the subgroup APACHE II 11 to 25

Conclusions

We found a better adherence to the FAST HUG items among intensive care physicians.