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Volume 3 Supplement 1

ESICM LIVES 2015

  • Poster presentation
  • Open Access

Impact of oncologic pathology (OP) in the evolution of severe sepsis (SS) in the critically ill patients (CIP)

  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 2
Intensive Care Medicine Experimental20153 (Suppl 1) :A247

https://doi.org/10.1186/2197-425X-3-S1-A247

  • Published:

Keywords

  • Public Health
  • Cardiac Output
  • Replacement Therapy
  • Severe Sepsis
  • Renal Replacement Therapy

Intr

It is considered that the severity of septic CIPs is higher than the overall CIPs requiring ICU admission. Nevertheless, the impact of the OP over the severity of the SS perhaps has not been sufficiently analyzed and evaluated.

Objectives

To evaluate the impact of the OP in the evolution of the SS of the CIPs.

Methods

· Study: prospective, analytical, longitudinal, and observational
  • · Period: January 1-2011 / June 30-2014 (42 months)

  • · SETTING. Medical/Surgical ICU

  • · Population: 2559 CIPs admitted consecutively to the ICU; sample: 484 CIPs with SS.

· Exclusión criteria: CIPs < 16 y., major burn CIPs, incomplete clinical documentation, and voluntary discharge.

· Variables analyzed:

a) Age

b) Hospital mortality

c) Case - mix: metabolic acidosis, total parenteral nutrition, intra-abdominal pressure (IAP), blood products, cultures, cardiac output, renal replacement therapy (RRT), advanced life support (ALS), FGC, FBC,

e) Organ dysfunction: SOFA and LODS

f) Limitation of life support (LLS).

· Statistical analysis: Ji squared and contrast of means (Student's t)

· Limitations of the study: absence of critically burned patients and pediatric CIPs

Results

Global CIPs: 2559; sepsis CIPs: 484; non sepsis CIPs: 2075

SOFA: Global (2.70), septic CIPs (5,32), non-septic CIPs (1,90)

LODS: Global (1.37), septic CIPs (2,78), non-septic CIPs (0,94)

See Tables 1 and 2.

Table 1

 

Global

%

SS

%

SS with OP

%

SS witout OP

%

p value

N

2559

100

484

18,9

130

26,9

354

73,1

 

Age

65,88

16,7

73,5

13,1

73,18

11,4

73,64

13,7

NS

Mortality

182

7,1

120

24,8

39

30,0

81

22,9

NS

RRT

91

3,6

70

14,6

20

15,8

50

14,1

NS

TPN

467

18,2

184

38,0

90

69,3

94

26,5

0,0001

IAP

136

5,3

101

20,8

37

28,6

64

18,1

0,012

Metb acid

955

37,3

368

76,0

113

86,9113

255

72,0

0,0006

Table 2

 

Global

%

SS

%

SS with OP

%

SS witout OP

%

p value

Blood products

500

19,5

216

44,6

83

63,8

133

37,6

0,0001 NS NS

Cultures

689

26,9

456

94,2

119

91,5

337

95,2

NS

Pericardiocent.

8

0,3

3

0,6

2

1,5

1

0,9

NS

ALS

85

3,3

42

8,7

16

12,3

26

7,3

0,085

FGC

54

2,1

28

5,8

8

6,1

20

5,6

NS

FBC

61

2,3

47

9,7

12

9,2

35

9,9

NS

LLS

220

8,6

122

25,2

41

31,5

81

22,9

0,0518

Conclusions

1) The OP conditions not age or mortality of CIPs with SS.

2) Metabolic acidosis and the need of TPN, IAP and blood products are higher in the SS with OP.

3) Cultures, RRT, ALS, FGC, and FBC are applied equally in both groups.

4) The LLS is applied more in the SS with OP.

Authors’ Affiliations

(1)
Critical Care Department, QuirónSalud Hospital Universitario Sagrat Cor, Barcelona, Spain
(2)
Critical Care Department, Hospital de Clínicas de Sabadell & QuirónSalud Hospital Universitario Sagrat Cor, Sabadell, Spain

References

  1. Phillips R, Hancock B, Graham J, Bromham N, Jin H, Berendse S: Prevention and management of neutropenic sepsis in patients with cancer: summary of NICE guidance. BMJ. 2012, 345: e5368-PubMedView ArticleGoogle Scholar
  2. Corcuera Romero de la Devesa R, Ruiz Moreno J, González Marín E, Esteve Paños MJ, Godayol Arias S, Conesa Folch N, Rinaudo Videla M, Artigas Raventós A: Evaluation of severity in critically ill patientes (CIPS) with sepsis. European Society of Intensive Care Medicine, 27th Annual Congres. 2014, Barcelona, Spain, SeptemberGoogle Scholar
  3. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R: Mortality Related to Severe Sepsis and Septic Shock Among Critically Ill Patients in Australia and New Zealand, 2000-2012. JAMA. 2014, 311 (13): 1308-1316.PubMedView ArticleGoogle Scholar

Copyright

© Ruiz Moreno et al.; 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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