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2012, Number 1

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Rev Cub Med Int Emerg 2012; 11 (1)

Result of the non-sustained low blood pressure in sepsis patients admitted in the intensive care unit

Gutiérrez GL, Sánchez RE, García GA

Language: Spanish
References: 28
Page: 2374-2384
PDF size: 231.59 Kb.


ABSTRACT

Introduction: The infectious diseases are a serious problem of the world public health due to its frequency and high associated mortality.
Objectives: To determine the relation between the non-sustained low blood pressure and the mortality in sepsis patients.
Methods: A descriptive and prospective study was conducted in the patients admitted in the Intensive Care Unit (ICU) of the “Carlos J. Finlay” Hospital. Sample was obtained from a universe of 379 patients by systemic randomized probabilistic sampling remaining 131 patients divided into two groups: hypotensive and non-hypotensive according to the a systolic pressure ‹ 90 mmHg and during less than 60 minutes.
Results: Mean age was of 61,9 ± 17,6 years. The more frequent non-communicable chronic disease was the high blood pressure. The complicated postoperative period was the more frequent diagnosis at admission and infection in the surgical site was the more frequent complication. the patients with non-sustained hypotension had a greater mortality statistically significant X2: 4.32; p = 0,03 and a risk to die of 2,06. The was predominance of patients aged over 50 in both sexes.
Conclusions: Patients presenting with sepsis and also hypotensive over a time less than 60 minutes had twice more probabilities to die. Mortality increased with age. The three-quarter of patients were carriers of chronic and degenerative diseases.


REFERENCES

  1. León GC, García CR, Moya MM, Artigas RA, Borges MS, Candel GF, Chanovas BM, Ferrer RR, Jiménez AJ, Loza V, Sánchez GM. Consensus document (SEMES-SEMICYUC). Recommendations for the initial and multidisciplinary diagnostic management of severe sepsis in the hospital Emergency Departments. Med Intensiva. 2007; 31: 375-87 [Consultado: 18 Nov. 2008]; Disponible en: http://www.doyma.es

  2. Trzeciak S, Dellinger RP, Abate NL, Cowan RM, Stauss M, Kilgannon JH, et al. Translating Research to Clinical Practice. Chest 2006:129; 225-32. [Consultado: 6 Enero 2009]; Disponible en: http://chestjournal.chestpubs.org/content/129/2/225.full.

  3. Bone RC, Balk RA, Cerra FA, Dellinger RP. Definitions for Sepsis and organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis the accp/sccm consensus conference committee. Chest 1992 101:1644-55. [Consultado: 5 Mayo 2009]; Disponible en: http://chestjournal.chestpubs.org/content/101/6/1644.full.

  4. Russell JA. Management of Sepsis Drug Therapy. N Engl J Med 2006 355:1699-713 [Consultado: 12 Agosto 2009]; Disponible en: http://www.nejm.org.

  5. Laupland KB, Kirkpatrick AW, Kortbeek JB, Zuege DJ. Long-term mortality outcome associated with prolonged admission to the ICU. Chest. 2006; 129:4:954-9.

  6. Álvarez AA, González AJ, Rodríguez BL, Peña G, Berdú SJ, Hernández G ME. Sepsis extrahospitalaria severa en la Unidad de Cuidados Intensivos MAPFRE Medicina. 2006; 17: 3: 159-65.

  7. Glance LG, Li Y, Osler TM, Dick A, Mukamel DB. Impact of patient volume on the mortality rate of adult intensive care unit patients. Crit Care Med 2006; 34: 1925-34.

  8. Jones AE, Brown MD, Trzeciak S, Shapiro NI, Garrett JS, Heffner AC, et al. Emergency Medicine Shock Research Network Investigators. The effect of a quantitative resuscitation strategy on mortality in patients with sepsis: a meta-analysis. Crit Care Med 2008; 36: 2734-39.

  9. Valenzuela F, Bohollo R, Monge I, Gil A. Shock séptico. Med Intensiva 2005; 29:3:192-200.

  10. Silva E, Pedro M, Sogayar ACB, Mohovic T, Silva CL, Janiszewski M, et al. Brazilian sepsis epidemiological study (BASES study). Crit Care 2008; 8:251-60.

  11. Brun BC, Meshaka P, Pinton P, Vallet B, EPISEPSIS Study Group. EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units. Intensive Care Med 2004; 30:580-88.

  12. Marchick ME, Kline J, Jones EA. The significance of non-sustained hypotension in emergency department patients with sepsis. Intensive Care Med 2009; 35:1261-64.

  13. Blanco J, Muriel-Bombin A, Sagredo V, Taboada F, Gandía F,Tamyo L, et al. Incidence, organ dysfunction and mortality in severe sepsis: a Spanish multicentre study. Critical Care 2008; 12: 6:1-14. [Consultado: 20 Abril 2009]; Disponible en: http://ccforum.com/content/12/6/r158

  14. Jones EA, Aborn SL, Kline AJ. Severity of emergency department hypotension predicts adverse hospital outcome. SHOCK 2004; 22:5: 410-14.

  15. Dünser WM, Takala J, Ulmer H, Mayr DV, Luckner G, Jochberger S, et al. Arterial blood pressure during early sepsis and outcome. Intensive Care Medicine 2009; 35:1225-33.

  16. Jones EA, Stiell IA, Nesbitt PL, Spaite WD, Hasan N, Watts BA, et al. Nontraumatic Out-of-Hospital Hypotension Predicts In hospital Mortality. Ann Emerg Med 2004; 43:106-13.

  17. Vaeza NN, Lorente BJA, Leyba OC, Valenzuela SF, Baigorri GF, López RA, et al. Estudio multicentrico sobre la asociación entre variables relacionadas con la resucitación y la mortalidad en la sepsis grave. Med Intensiva 2005; 29:4:212-8.

  18. Iñigo J, Sendra JM, Díaz R, Bouza C, Sarría S. Epidemiología y costes de la sepsis grave en Madrid. Estudio de altas hospitalarias. A Med Intensiva 2006; 30:5.

  19. Martínez FJA, Fernández DIE. Ancianos y salud. Rev Cubana Med Gen Integr 2008; 24:4 -6.

  20. Anuario estadístico de Cuba 2010. Situación de Salud en Cuba. Indicadores básicos [Serial en Internet]. [Consultado: 17 Abril 2011]. Disponible en: www.infomed.sld.cu

  21. Liñan PJI, Veliz VF. Características clínicas de los pacientes con sepsis admitidos a una Unidad de Cuidados Intensivos. Rev Soc Perú Med Interna 2008;21:4:139-42

  22. Hennessey DB, Burke JP, Ni-Dhonochu T, Shields C, Winter DC, Mealy K. Preoperative Hypoalbuminemia is an Independent Risk Factor for the Development of Surgical Site Infection Following Gastrointestinal Surgery: A Multi-Institutional Study. Annals of Surgery [serial en Internet]. 2010; 252(2): 325-29. [Consultado: 13 Abril 2011] Disponible en: http://journals.lww.com/annalsofsurgery/Abstract/2010/08000

  23. Hernández TA, Morales AJC, Gutiérrez GL. Comportamiento de la sepsis nosocomial en la sala de Cuidados intensivos. Rev Cub Med Int Emerg [serial en Internet]. 2002 [Consultado: 5 Diciembre 2009]; 1:29-31. Disponible en: http://www.bvs.sld.cu/revistas/vol1_3_02/

  24. Vesteinsdottir E, Karason S, Sigurdsson SE, Gottfredsson M, Sigurdsson GH. Severe sepsis and septic shock: a prospective population-based study in Icelandic intensive care units. Acta Anaesthesiol Scand 2011; 11: 1399-576.

  25. Finfer S, Chittock D, Ronco J. SIIC control estricto de la glicemia en las UCI. N Engl J Med [serial en Internet]. 2009; 306(13):1283-972009 [Consultado: 7 Nov. 2009]; Disponible en: http://www.nejm.org/

  26. Linder A, Christensson B, Herwald H, Björck L, Akesson P. Heparin-binding protein: an early marker of circulatory failure in sepsis. Clin Infect Dis 2009; 49: 1044-50.

  27. Jones AE, Yiannibas V, Johnson C, Kline JA. Emergency Department Hypotension Predicts Sudden Unexpected In-hospital Mortality a Prospective Cohort Study. Chest 2006; 130; 941-46.

  28. Levinson AT, Casserly BP, Levy MM. Reducing Mortality in Severe Sepsis and Septic Shock Semin Respir Crit Care Med. 2011; 32(2):195-205.




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