Social, clinical and hemodynamic variables associated with sepsis in patients at Intensive Care Unit
DOI:
https://doi.org/10.33448/rsd-v11i2.25399Keywords:
Sepsis; Systemic Inflammatory Response Syndrome; Critical care.Abstract
Objective: Analyze the social, clinical and hemodynamic variables of patients admitted to the Intensive Care Unit (ICU) who developed sepsis. Methodology: Retrospective, observational and cross-sectional study. 224 medical records were eligible, divided into two groups: present sepsis (SP) n = 165 and absent sepsis (SA) n = 59. Social, clinical and hemodynamic variables were described and analyzed. Results: The social variables low schooling and married marital status were associated with sepsis. In the clinical variables, it was observed that patients who need invasive interventions were associated with sepsis. The hemodynamic variables PaCO2, Be, Bicarbonate, leukocytes, red blood cells, urea, sodium and potassium altered were associated with sepsis. These patients remained longer in the ICU and died more frequently. Conclusion: There are specific social, clinical and hemodynamic variables that are related to the presence of sepsis. Knowledge of these variables can guide investments and resources to be directed towards preventing this clinical complication.
References
Antal, O., Ștefănescu, E., Mleșnițe, M., Bălan, A. M., Caziuc, A. & Hagău, N (2020). Hemodynamic Predictors for Sepsis-Induced Acute Kidney Injury: A Preliminary Study. Journal of Clinical Medicine, 9(1), 151. 10.3390/jcm9010151.
Assmann, C. B., Vieira, P. J. C., Kutchak, F., Rieder, M. M., Forgiarini, S. G. I. & Junior, L. A. F. (2016). Lung hyperinflation by mechanical ventilation versus isolated tracheal aspiration in the bronchial hygiene of patients undergoing mechanical ventilation. Rev. bras. ter. intensiva, 28(1): 27–32. 10.5935/0103-507X.20160010.
Chen, L., Meng, K., Wei, S. & Yanjie, F. (2015). The Effect of Continuous Sedation Therapy on Immunomodulation, Plasma Levels of Antioxidants, and Indicators of Tissue Repair in Post-Burn Sepsis Patients. Cell Biochemistry and Biophysics, 73(2): 473-478. 10.1007/s12013-015-0681-x.
Da Silva, E. P., Duarte, V. C., Soares, M. M., Melo, A. T. M., Calife, E. R., Rebouças, G. S. & De Souza, D. L. B. (2019). Survival analysis of patients with sepsis in Brazil. Rev. Soc. Bras. Med. Trop., 52: e20180121. https://doi.org/10.1590/0037-8682-0121-2018.
De Figueiredo, L. F. P., Silva, E., Correa, T. D. (2008). Avaliação hemodinâmica macro e micro-circulatória no choque séptico. Rev Med (São Paulo), abr.-jun.;87(2):84-91. https://doi.org/10.11606/issn.1679-9836.v87i2p84-91
De Freitas, G., Gudu, A. & Krishnamurthy, M. (2019). Where there is sodium there may be sepsis. Journal of Community Hospital Internal Medicine Perspectives, 9(4): 296-299. doi:10.1080/20009666.2019.1634407
Dugani, S., Veillard, J. & Kissoon, N. (2017). Reducing the global burden of sepsis. CMAJ, 189 (1): E2-E3. 10.1503/cmaj.160798.
Engchuan, W., Dimopoulos, A. C., Tyrovolas, S., Caballero, F. F., Sanchez-Niubo, A., Arndt, H. & Panagiotakos, D. B. (2019). Sociodemographic Indicators of Health Status Using a Machine Learning Approach and Data from the English Longitudinal Study of Aging (ELSA). Med Sci Monit., 25: 1994–2001. 10.12659/MSM.913283
Franchini, M., Veneri, D. & Lippi, G. (2017) Thrombocytopenia and infections. Expert review of hematology, 10(1): 99–106. 10.1080/17474086.2017.1271319.
Genga, K.R. & Russell, J.A. (2017). Update of sepsis in the intensive care unit. J Innate Immun, 2017; 9(5): 441-455. 10.1159/000477419.
Gucyetmez, B. & Atalan, H. K. (2016). C-Reactive Protein and Hemogram Parameters for the Non-Sepsis Systemic Inflammatory Response Syndrome and Sepsis: What Do They Mean?. PLoS One, 10;11(2): e0148699. 10.1371/journal.pone.0148699.
IJzendoorn, M. V., Born, J. V. D., Hijmans, R., Bodde, R., Buter, H., Dam, W., & Boerma, C. (2019). An observational study on intracutaneous sodium storage in intensive care patients and controls. PLoS One, 14(10): e0223100. 10.1371/journal.pone.0223100.
Jones, L., Bates, G., McCoy, E. & Bellis, M. A. (2015). Relationship between alcohol-attributable disease and socioeconomic status, and the role of alcohol consumption in this relationship: a systematic review and meta-analysis. BMC Public Health, 15: 400. 10.1186/s12889-015-1720-7.
Lai, C.C., Tseng, K.L., Ho, C.H., Chiang, S. R, Chen, C. M, Chan, K. S. & Cheng, K. C. (2019). Prognosis of patients with acute respiratory failure and prolonged intensive care unit stay. J Thorac Dis., 11(5):2051-2057. 10.21037/jtd.2019.04.84.
Machado, F. R., Cavalcanti, A. B., Bozza, F. A., Ferreira, E. M., Carrara, F. S. A., Sousa, J.L., & Azevedo, L. C. P. (2017). The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. Lancet Infect Dis, 17(11): 1180-1189. 10.1016/S1473-3099(17)30322-5.
Marshall, J. C. (2018). Sepsis definitions: a work in progress. Crit Care Clin., 34(1): 1-14. 10.1016/j.ccc.2017.08.004.
Martin, D. S. & Grocott, M. P. W. (2013). Oxygen therapy in critical illness: precise control of arterial oxygenation and permissive hypoxemia. Critical Care Med., 41(2): 423-432. 10.1097/CCM.0b013e31826a44f6.
Martins, E. C., Silveira, L. F., Viegas, K., Beck, A. D., Júnior, G. F., Cremonese, R.V., & Lora, P. S. (2019). Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study. Rev. bras. ter. intensiva, 31(1): 64-70. 10.5935/0103-507X.20190010.
Mayr, F. B., Yende, S. & Angus, D. C. (2014). Epidemiology of severe sepsis. Virulence, 41(2): 423-32. 10.4161/viru.27372.
Missão (2019). Hospital Universitário João de Barros Barreto – HUJBB. http://www.barrosbarreto.ufpa.br/index.php/institucional/missao.
Mohamed, A. K. S., Mehta, A. A. & James P. (2017). Predictors of mortality of severe sepsis among adult patients in the medical Intensive Care Unit. Lung India, 34(4): 330-335. 10.4103/lungindia.lungindia_54_16.
Nguyen, D. L. (2017). Guidance for supplemental enteral nutrition across patient populations. Am J Manag Care., 23 (12 Supl): S210-S219. Retrieved from https://www.ajmc.com/view/guidance-for-supplemental-enteral-nutrition-across-patient-populations-articles
Noritomi, D. T., Soriano, F. G., Kellum, J. A., Cappi, S. B., Biselli, P. J. C., Libório, A. B., & Park, M. (2009). Metabolic acidosis in patients with severe sepsis and septic shock: a longitudinal quantitative study. Crit Care Med., 37(10): 2733−2739. 10.1097/ccm.0b013e3181a59165.
Oestergaard, L. B., Schmiegelow, M. D., Bruun, N. E., Skov, R. L., Petersen, A., Andersen, P. S., & Torp-Pedersen, C. (2017). The associations between socioeconomic status and risk of Staphylococcus aureus bacteremia and subsequent endocarditis - a Danish nationwide cohort study. BMC Infectious Diseases, 17(1): 589. 10.1186/s12879-017-2691-3.
Sakr, Y., Jaschinski, U., Wittebole, X., Szakmany, T., Lipman, J., Ñamendys-Silva, S. A., & Vincent, J. L. (2018). Sepsis in Intensive Care Unit Patients: Worldwide Data From the Intensive Care over Nations Audit. Open Forum Infectious Diseases, 5(12): ofy313. 10.1093/ofid/ofy313.
Salomão, R., Ferreira, B. L., Salomão, M. C., Santos, S. S., Azevedo, L. C. P. & Brunialti, M. K. C. (2019). Sepsis: evolving concepts and challenges. Braz J Med Biol Res, 52(4): e8595. 10.1590/1414-431X20198595.
Schulz, K. F., Altman, D. G., Moher, D., for the CONSORT Group. CONSORT (2010) Statement: updated guidelines for reporting parallel group randomised trials. https://www.equator-network.org/reporting-guidelines/consort/
Seymour, C. W., Iwashyna, T. J., Cooke, C. R., Hough, C. L. & Martin, G. S. (2010). Marital status and the epidemiology and outcomes of sepsis. Chest, 137 (6): 1289-1296. 10.1378/chest.09-2661.
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., & Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, 315(8): 801–810. 10.1001/jama.2016.0287.
Storm, L., Schnegelsberg, A., Mackenhauer, J., Andersen, L. W., Jessen, M. K. & Kirkegaard, H. (2018). Socioeconomic status and risk of intensive care unit admission with sepsis. Acta Anaesthesiol Scand., 62(7): 983-992. 10.1111/aas.13114.
Szakmany, T., Lundin, R. M., Sharif, B., Ellis, G., Morgan, P., Kopczynska, M., & Hall, J. E. (2016). Sepsis prevalence and outcome on the general wards and emergency departments in Wales: results of a multi-centre, observational, point prevalence study. PLoS One, 11(12): e0167230. 10.1371/journal.pone.0167230.
Szrama, J. & Smuszkiewicz, P. (2016). An acid-base disorders analysis with the use of the Stewart approach in patients with sepsis treated in an intensive care unit. Anesthesiol Intensive Ther., 48(3): 180-184. 10.5603/AIT.a2016.0020.
Tsertsvadze, A., Royle, P., Seedat, F., Cooper, J., Crosby, R. & McCarthy, N. (2016). Community-onset sepsis and its public health burden: a systematic review. Systematic Reviews, 5: 81. 10.1186/s13643-016-0243-3.
Vender, J. S., Szokol, J. W., Murphy, G. S. & Nitsun, M. (2004). Sedation, analgesia, and neuromuscular blockade in sepsis: an evidence-based review. Critical Care Med., 32(11 Supl): S554-561. 10.1097/01.ccm.0000145907.86298.12.
Venkata, C., Kashyap, R., Farmer, J. C. & Afessa, B. (2013). Thrombocytopenia in adult patients with sepsis: incidence, risk factors, and its association with clinical outcome. J Intensive Care., 30;1(1):9. 10.1186/2052-0492-1-9.
Westphal, G. A., Pereira, A. B., Fachin, S. M., Barreto, A. C. C., Bornschein, A, C, G, J., Filho, M. C., & Koenig, A. (2019). Characteristics and outcomes of patients with community-acquired and hospital-acquired sepsis. Rev. bras. ter. intensiva, 31(1): 71-78. 10.5935/0103-507X.20190013.
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Copyright (c) 2022 Edila Monteiro de Andrade; Thalia Saraiva Mendonça; Cleuma Oliveira Soares; Giovana Salomão Melo; Isabella Boechat Faria Santos; João Simão de Melo-Neto
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