Association between base excess and 28-day mortality in sepsis patients: A secondary analysis based on the MIMIC- IV database

Yuan, Jia; Liu, Xu; Liu, Ying; Li, Wei; Chen, Xianjun; Chen, Qiming; Xiao, Chuan; Wang, Ying; Li, Shuwen; Li, Qing; Li, Lü; He, Juan; Chen, Lu; Shen, Feng

doi:10.1016/j.heliyon.2023.e15990

Cited by 2 publications

(3 citation statements)

References 31 publications

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“…Extreme variations in Pa co 2 indicate that acidotic and alkalotic states increase sepsis-related mortality 30 . Studies suggest that low and high levels of Pa co 2 result from dysregulated oxygen consumption as well as impair the immune response, promote the proliferation of the bacterial pool, and worsen organ injury, particularly in the lungs 30 . Pa co 2 measures can assist clinicians in addressing perfusion issues in septic patients to optimize treatment regimens.…”

Section: Dysregulated Immunological Response In Sepsismentioning

confidence: 99%

Embracing a New Evidence-Based Thought Paradigm of Sepsis

Richardson,

Graham

2024

Clin Nurse Spec

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In 1991, sepsis was first defined by the Society of Critical Care Medicine as the systemic inflammatory response syndrome, in the presence of infection. Systemic inflammatory response syndrome is an adaptive host response to infection, as well as to other insults like trauma and stress. Research pertaining to sepsis was guided by this adaptive definition for 25 years. After established guidelines for sepsis management were challenged in 2014, sepsis was redefined in 2016 as a dysregulated host response to infection. However, there still remains no consensus on which immunologic or metabolic mechanisms have become dysregulated. We sought to examine sepsis literature published after the 2016 consensus definition and compare it to the original systemic inflammatory response syndrome paradigm proposed in 1991. The purpose of this intensive analysis was to recommend a new sepsis archetype, with consideration to dysregulated immunologic and metabolic mechanisms that have recently been identified in sepsis. Nurses and other clinicians must shift their thought paradigm toward an evidence-based dysregulated model, in order to improve on sepsis recognition and management.

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Section: Dysregulated Immunological Response In Sepsismentioning

confidence: 99%

Embracing a New Evidence-Based Thought Paradigm of Sepsis

Richardson,

Graham

2024

Clin Nurse Spec

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“…Our study did not utilize lactate to assess tissue hypoperfusion, as excessive lactate deficiency can lead to unreliable results. A study reveals that increase of negative value of BE values can better reflect hypoperfusion-induced metabolic acidosis in critically ill patients compared to lactate ( 46 ). These findings also offset certain limitations in our study.…”

Section: Discussionmentioning

confidence: 99%

“…These findings also offset certain limitations in our study. Moreover, low serum levels of both bicarbonate and BE are indicative of a higher mortality in critically ill patients ( 46 - 49 ). These studies support our conclusions while further enhancing our understanding of the association between these indicators and neonatal mortality.…”

Section: Discussionmentioning

confidence: 99%

A nomogram to predict 28-day mortality in neonates with sepsis: a retrospective study based on the MIMIC-III database

Liang,

Zhao,

Huang

et al. 2023

Transl Pediatr

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Background Sepsis is the second-leading cause of death in neonates. We established a predictive nomogram to identify critically ill neonates early and reduce the time to treatment. Methods It is a retrospective case-control study based on the MIMIC-III database. The study population comprised 924 neonates diagnosed with sepsis. Results Neonates with sepsis included in the MIMIC-III database were enrolled, including 880 surviving neonates and 44 neonates who died. In the derivation dataset, stepwise regression and the Lasso algorithm were employed to select predictive variables, and the neonatal sequential organ failure assessment score (nSOFA) was calculated simultaneously. Bootstrap resampling was utilized to perform internal validation. The results indicated that the Lasso algorithm displayed superior discrimination, sensitivity, and specificity relative to stepwise regression and nSOFA scores. After 500 bootstrap resampling tests, the area under the receiver operating characteristic curve (AUC) of the Lasso algorithm was 0.912 (95% CI: 0.870–0.977). The nomogram based on the Lasso algorithm outperformed stepwise regression and nSOFA scores in terms of calibration and the clinical net benefit. This nomogram can assist in prognosticating neonatal severe sepsis and aid in guiding clinical practice while concurrently improving patient outcomes. Conclusions The established nomogram revealed that jaundice, corticosteroid use, weight, serum calcium, inotropes and base excess are all important predictors of 28-day mortality in neonates with sepsis. This nomogram can facilitate the early identification of neonates with severe sepsis. However, it still requires further modiﬁcation and external validation to make it widely available.

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Association between base excess and 28-day mortality in sepsis patients: A secondary analysis based on the MIMIC- IV database

Cited by 2 publications

References 31 publications

Embracing a New Evidence-Based Thought Paradigm of Sepsis

Embracing a New Evidence-Based Thought Paradigm of Sepsis

A nomogram to predict 28-day mortality in neonates with sepsis: a retrospective study based on the MIMIC-III database

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