Update of Sepsis in the Intensive Care Unit

Genga, Kelly Roveran; Russell, James A.

doi:10.1159/000477419

Cited by 116 publications

(92 citation statements)

References 107 publications

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“…Sepsis, the most common cause of intensive care admission, is also the most common cause of death in the intensive care unit. Despite all advances in treatment, mortality is around 20-30% (9). According to a meta-analysis, mortality rates in ICU in sepsis can reach 40-60% (10).…”

Section: Discussionmentioning

confidence: 99%

“…The median ages of the patients were 68 (54.2-79) years, and 239 (61%) were male. Median Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) values were 24.5 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27) and 11 (9)(10)(11)(12), respectively. While the duration of ICU stay was 10(4-22) days, the rates of patients with invasive mechanical ventilation, blood and blood products transfusion and acute kidney injury were 96.9% (380 patients), 58.9% (231 patients) and 26.3% (103 patients), respectively.…”

Section: General Characteristics Of Patients With Sepsis / Septic Shockmentioning

confidence: 99%

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The use of Vasoactive-Inotropic Score in Adult Patients with Septic Shock in Intensive Care

Kara¹,

Sargın²,

Bayraktar³

et al. 2019

Yoğun Bakım Derg

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Objective: Sepsis and septic shock are significant causes of mortality and morbidity. In septic shock, vasopressors and inotropic support are given for the treatment of hypotension. This study was designed to investigate the relationship between the vasoactive-inotropic score (VIS) and the results of sepsis patients in ICU. Methods: The data of 392 patients who were followed up with the diagnosis of septic shock in adult ICU were recorded retrospectively. Vasopressors and inotropic support of the patients during the first 48 hours after the diagnosis of septic shock were recorded. Mean and peak VIS values were calculated according to these values. The patients were divided into groups according to the mean VIS≥10, peak VIS≥10 and intensive care results and statistical analysis was performed. Results: The median ages of the patients were 68 (54.25-79) years and 239 (61%) were male. Dopamine 188 (47.9%), noradrenaline 365 (93.1%), adrenaline 53 (13.5%) and dobutamine 15 (3.8%) were used in the patients. The mean VIS was 9 (4-15), while the number of mean VIS≥10 patients were 192 (49%). Peak VIS values were 11 (5-20), and the number of peak VIS ≥10 patients were 220 (56.1%). The mortality rate of the patients included in the study was 42.1%. The mean VIS score(13 vs 6, p=0.000), mean VIS≥10 patient ratio (71.5% vs 32.6%, p=0.000), peak VIS score (16 vs 8, p=0.000), and peak VIS ≥10 patient ratio (73.3% vs 43.6%, p=0.000) were higher in non-survivors. The parameters such as mean VIS [OR 1.123, 95% CI 1.027-1.229, p=0.011], mean VIS≥10 [OR 3.455, 95% CI 1.625-7.345, p=0.001] and peak VIS score [OR 0.917, 95% CI 0.851-0.989, p=0.024] were determined as independent risk factors for mortality. Conclusion: We conclude that vasoactive-inotropic score may be useful in predicting the outcome of septic shock patients in intensive care units.

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Section: Discussionmentioning

confidence: 99%

Section: General Characteristics Of Patients With Sepsis / Septic Shockmentioning

confidence: 99%

The use of Vasoactive-Inotropic Score in Adult Patients with Septic Shock in Intensive Care

Kara¹,

Sargın²,

Bayraktar³

et al. 2019

Yoğun Bakım Derg

View full text Add to dashboard Cite

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“…In patients with severe infectious diseases, systemic inflammatory responses, such as a cytokine storm, are part of the clinical picture [9,10]. These life-threatening conditions are often a consequence of a pathological activation of pattern recognition receptors (PRRs) by microbial pathogens [11].…”

Section: Going Fishingmentioning

confidence: 99%

Going Fishing

2018

J Innate Immun

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“…The close follow-up of the cultures and biomarkers received after the hospitalization of the patients is very important for their survival. [8] However, when the pathogens causing the disease are identified, it is recommended to stop or reduce the use of antibiotics and/or narrow their spectrums. This strategy, which is called "De-escalation therapy (DE)", promotes therapeutic compliance, reduces costs and appears to be quite correct theoretically.…”

mentioning

confidence: 99%

The Effects Of De-Escalation Under the Guidance of Procalcitonin in Sepsis

Şeker¹

2019

EJMI

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F or patients diagnosed with sepsis or septic shock, an empirical broad-spectrum therapy with one or more antimicrobial agents is recommended to cover all possible pathogens (bacterial, fungal or viral agents). [1] The majority of current studies have focussed on the development and prevention of antimicrobial resistance. [2,3] Empirical antibiotic regimens should be selected based on the local resistance characteristics, the risk of development of the Objectives: The present study aimed to monitor the effects of antibiotic use under the guidance of culture and procalcitonin in patients admitted to the intensive care unit (ICU) due to sepsis or septic shock. Methods: This prospective, cross-sectional, clinical trial was conducted on patients admitted with sepsis or septic shock to Dr. Sadi Konuk Training and Research Hospital Anesthesia and Reanimation Clinic Intensive Care Unit between 01.01.2018 and 30.06.2018. For each patient a record was made of demographic data, reason for hospitalization reasons, PCT, C-reactive protein (CRP), blood leukocyte levels (WBC), lymphocyte percentages, neutrophil percentages, platelet (Plt) counts on admission, in the 72 nd hour and on the 7 th day, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores at the time of hospitalization and discharge, Sequential Organ Failure Assessment (SOFA) scores and modes of discharge (exitus, recovery). The blood, tracheal aspirate, urine and/or tissue cultures of the patients were followed. The patients who met the criteria underwent DE. Results: The study included a total of 186 patients, comprising 102 (54.8%) males and 84 (45.2%) females, with a mean age of 66.64±17.6 years. DE was applied to 97 patients (52%) in the first 72 hours. Culture positivity obtained in the first 72 hours was higher in patients who underwent DE (OR=3.1, 1.6-6.5, CI=95%, p=0.001). It was seen that patients who underwent DE with culture positivity had a shorter stay in the intensive care unit (p=0.046). When the procalcitonin levels were analyzed, no statistically significant difference was found between the culture-positive DE group and the culture-negative DE group. Conclusion: In conclusion, the culture results guide the DE management in patients who are followed up with the clinical picture of infection in the intensive care unit. It is thought that PCT monitoring can be used as a guideline for the discontinuation of broad-spectrum antibiotics in culture-negative infectious patients. There is a need for more extensive studies related to this subject to investigate survival outcomes.

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Update of Sepsis in the Intensive Care Unit

Cited by 116 publications

References 107 publications

The use of Vasoactive-Inotropic Score in Adult Patients with Septic Shock in Intensive Care

The use of Vasoactive-Inotropic Score in Adult Patients with Septic Shock in Intensive Care

Going Fishing

The Effects Of De-Escalation Under the Guidance of Procalcitonin in Sepsis

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