Declining mortality due to severe sepsis and septic shock in Spanish intensive care units: A two-cohort study in 2005 and 2011

Sánchez, Baltasar; Ferrer, Ricard; Suarez, David L.; Romay, E.; Piacentini, Enrique; Gomà, Gemma; Martínez, María Luisa Martínez; Artigas, Antonio

doi:10.1016/j.medin.2016.09.004

Cited by 14 publications

(12 citation statements)

References 42 publications

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“…Common themes that emerged from this ILR were: First, implementing the SSC guidelines can decrease the mortality rate among adult patients with sepsis and SS in ICUs; this corresponds to the findings of Lefrant et al [37], Leisman et al [38], Patel et al [33], Pestana et al [21], Cardoso et al [35], Memon et al [39], Sánchez et al [41], Thompson et al [42], van Zanten et al [43], and Levy et al [12]. The second emerged theme was that implementing certain selected guidelines, such as collecting blood cultures and administering broad-spectrum antibiotics and vasopressors can also reduce the mortality rate among adult ICU patients, which was consistent with the findings of Uvizl et al [44] and Ferrer et al There are some limitations of the reviewed studies.…”

Section: Discussionsupporting

confidence: 59%

“…However, the sample size was small in the observational study of Pestana et al [21], which may limit its generalizability. The studies of van Zanten et al [43], Thompson et al [42], Uvizl et al [44], Sánchez et al [41], and Leisman et al [38], recruited large numbers of participants. Moreover, the studies of Ferrer et al [45], Castellanos-Ortega et al [32], Patel et al [33], Shiramizo et al [34], Thompson et al [42], Chou et al [20], and Herrán-Monge et al [36] used convenient samples of patients, which might have carried a risk of sampling bias [46].…”

Section: Discussionmentioning

confidence: 99%

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Implementing Surviving Sepsis Campaign Guidelines and Mortality of Adult Patients in Intensive Care Units: An Integrative Review

Omar¹,

Khalaf²,

Alshraideh³

2019

OJN

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Background: Sepsis is a common dangerous body response to infection that can deteriorate into septic shock. Both sepsis and septic shock require early and timely managed care, which can be implemented by using the Surviving Sepsis Campaign (SSC) guidelines for management of sepsis and septic shock. The purpose of this study was to examine the literature related to the effect of implementing SSC guidelines for management of sepsis and septic shock on adult patients' mortality rate in Intensive Care Units (ICUs). Methods: The method of Whittemore and Knafl was used to guide this integrative literature review. The literature search revealed 16 eligible quantitative research studies between 2004 and 2018. The quality of methods used in the included articles was assessed and data were analyzed. Results: Results showed that implementing SSC guidelines reduced the mortality rate among adult patients in ICUs. In addition, implementing selected practices from SSC guidelines, such as collecting blood cultures and administration of a broad-spectrum antibiotic and vasopressors were found to decrease the mortality rate among adult patients in ICUs. The SSC guidelines need to be taught to nurses and nursing students to increase their awareness and capability of implementing these guidelines in clinical practice.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Implementing Surviving Sepsis Campaign Guidelines and Mortality of Adult Patients in Intensive Care Units: An Integrative Review

Omar¹,

Khalaf²,

Alshraideh³

2019

OJN

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“…One hundred and eighty patients came from the GRECIA study [9] (Grupo de Estudios y Análisis en Cuidados Intensivos), and 98 came from the ABISS-Edusepsis study (AntiBiotic Intervention in Severe Sepsis) [10]. In both studies, patients had sepsis at the time of admission to the ICU.…”

Section: Methodsmentioning

confidence: 99%

The protective association of endogenous immunoglobulins against sepsis mortality is restricted to patients with moderate organ failure

Martín‐Loeches¹,

Muriel-Bombín

Ferrer

et al. 2017

Ann. Intensive Care

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BackgroundPre-evaluation of endogenous immunoglobulin levels is a potential strategy to improve the results of intravenous immunoglobulins in sepsis, but more work has to be done to identify those patients who could benefit the most from this treatment. The objective of this study was to evaluate the impact of endogenous immunoglobulins on the mortality risk in sepsis depending on disease severity.MethodsThis was a retrospective observational study including 278 patients admitted to the ICU with sepsis fulfilling the SEPSIS-3 criteria, coming from the Spanish GRECIA and ABISS-EDUSEPSIS cohorts. Patients were distributed into two groups depending on their Sequential Organ Failure Assessment score at ICU admission (SOFA < 8, n = 122 and SOFA ≥ 8, n = 156), and the association between immunoglobulin levels at ICU admission with mortality was studied in each group by Kaplan–Meier and multivariate logistic regression analysis.ResultsICU/hospital mortality in the SOFA < 8 group was 14.8/23.0%, compared to 30.1/35.3% in the SOFA ≥ 8 group. In the group with SOFA < 8, the simultaneous presence of total IgG < 407 mg/dl, IgM < 43 mg/dl and IgA < 219 mg/dl was associated with a reduction in the survival mean time of 6.6 days in the first 28 days and was a robust predictor of mortality risk either during the acute or during the post-acute phase of the disease (OR for ICU mortality: 13.79; OR for hospital mortality: 7.98). This predictive ability remained in the absence of prior immunosuppression (OR for ICU mortality: 17.53; OR for hospital mortality: 5.63). Total IgG < 407 mg/dl or IgG1 < 332 mg/dl was also an independent predictor of ICU mortality in this group. In contrast, in the SOFA ≥ 8 group, we found no immunoglobulin thresholds associated with neither ICU nor hospital mortality.ConclusionsEndogenous immunoglobulin levels may have a different impact on the mortality risk of sepsis patients based on their severity. In patients with moderate organ failure, the simultaneous presence of low levels of IgG, IgA and IgM was a consistent predictor of both acute and post-acute mortalities.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0268-3) contains supplementary material, which is available to authorized users.

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“…Currently, sepsis remains the primary cause of death in intensive care units (ICU), despite recent advancements in medical technology (2,3). It has been estimated that in 2017, the percentage of admissions to the ICU caused by sepsis is ~25% and is associated with a mortality rate >50% worldwide (2,4). Although the precise pathophysiology of sepsis remains unclear, increasing evidence has indicated that it may move from an early hyper-inflammatory phase characterized by systemic inflammation induced by the excessive release of pro-inflammatory factors, followed by a late immuno-suppressive phase, characterized by the apoptosis of immune cells (including monocytes and lymphocytes) (5,6).…”

Section: Introductionmentioning

confidence: 99%

Long non‑coding RNA‑HOTAIR promotes the progression of sepsis by acting as a sponge of miR‑211 to induce IL‑6R expression

Chen

Zhou

et al. 2019

Exp Ther Med

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Sepsis remains the primary cause of death in intensive care units and multiple long non-coding RNAs (lncRNAs) have been demonstrated to be dysregulated in samples of patients with sepsis. However, whether lncRNA-HOTAIR is involved in the etiology of sepsis remains unclear. The aim of the present study was to investigate the role of HOTAIR in sepsis and to reveal the associated mechanisms. A bioinformatics analysis and dual-luciferase reporter assay was performed to evaluate the interaction between HOTAIR and miR-211, as well as miR-211 and IL-6R. An animal model of sepsis was established in mice via cecal ligation and puncture. Interferon (IFN)-γ, interleukin (IL)-6, IL-17, tumor necrosis factor (TNF)-α, IL-1β, IL-6 receptor (R), microRNA (miR)-211 and HOTAIR expression was measured using reverse transcription-quantitative PCR. Cellular proliferation and apoptosis of monocytes were assessed using cell counting kit-8 assay and flow cytometry, respectively. miR-211 was revealed to be targeted by HOTAIR and IL-6R. The expression of IFN-γ, IL-6, IL-17, TNF-α, IL-1β, IL-6R and HOTAIR was significantly upregulated in the septic mice, whereas miR-211 expression was downregulated. The overexpression of hox transcript antisense RNA (HOTAIR) and knockdown of miR-211 were associated with an increased expression of IFN-γ, IL-6, IL-17, TNF-α, IL-1β and IL-6R in monocytes, while the overexpression of miR-211 exhibited the opposite effect. HOTAIR overexpression and miR-211 knockdown significantly inhibited cellular proliferation and promoted monocyte apoptosis, whereas the overexpression of miR-211 exhibited the opposite effects in monocytes. Therefore, HOTAIR may promote the progression of sepsis by indirectly regulating the expression of IL-6R via miR-211.

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Declining mortality due to severe sepsis and septic shock in Spanish intensive care units: A two-cohort study in 2005 and 2011

Cited by 14 publications

References 42 publications

Implementing Surviving Sepsis Campaign Guidelines and Mortality of Adult Patients in Intensive Care Units: An Integrative Review

Implementing Surviving Sepsis Campaign Guidelines and Mortality of Adult Patients in Intensive Care Units: An Integrative Review

The protective association of endogenous immunoglobulins against sepsis mortality is restricted to patients with moderate organ failure

Long non‑coding RNA‑HOTAIR promotes the progression of sepsis by acting as a sponge of miR‑211 to induce IL‑6R expression

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