PP329 Topic: AS09–Global Health/Resource Limited Setting/Health Inequalities/Impact of Global Warming/Other: ADHERENCE TO PEDIATRIC SEPSIS TREATMENT RECOMMENDATIONS IN A LOW-INCOME COUNTRY

Aims & Objectives: Sepsis in low-income countries is one of the most important morbidity and mortality issues in hospitals with limited resources. Our objective was to obtain data on the epidemiology and mortality of sepsis and septic shock (SS), and to assess adherence to practice guidelines (CPGs) for the management in the first hour Methods: A multicenter, retrospective, descriptive cohort study was carried out that included 14 PICU patients in Bolivia between January and December 2023. The diagnosis of sepsis and SSc shock was made based on Sepsis–3 criteria, assessing time (minutes) of the start of the following items: 1) Placement of the first vascular access within the first 5 minutes, 2) Infusion of liquids within 30 minutes, 3) Start of antibiotics within 60 minutes, and 4) Start of Vasoactives within 60 minutes, finally overall adherence and/or compliance with the recommendations of the Surviving Sepsis campaign (SSC) was evaluated in addition to overall mortality. Results: 268 patients with sepsis and SS were included, 63% of patients obtained vascular access in the first 5 minutes but only 49% started fluid infusion within the first 30 minutes, 66% started antibiotics and vasoactive drugs in the first 60 minutes, 34.8% mortality was obtained in SS and 33% overall mortality in sepsis, Adherence to all treatment goals was achieved in 18%, associated with lower mortality rates (26% vs 38%; p =0.004)Conclusions: Low adherence to the guidelines and high mortality rates were found in the PICUs of a low-income country; prospective further studies are needed to evaluate improvement interventions. Keywords: Critical care, Children, septic shock, Bolivia, Sepsis