Outcome Predictors in Patients With Severe Sepsis and Optimized Central Venous Oxygen Saturation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Sepsis
- Sponsor
- National Taiwan University Hospital
- Enrollment
- 90
- Locations
- 2
- Primary Endpoint
- 28-day Mortality
- Status
- Completed
- Last Updated
- 14 years ago
Overview
Brief Summary
The investigators perform a prospective observation study to search for the outcome predictors (ScvO2 and lactate) in patients with severe sepsis after admission to ICU.
Detailed Description
Early goal-directed therapy in patients with severe sepsis or septic shock was found to provide survival benefit.It was thought that early optimization of ScvO2 within 6 hours in emergency department brought survival benefit to patients of septic shock or severe sepsis.On the other hand, early lactate clearance is associated with improved outcome in patients with severe sepsis or septic shock. In patients with severe sepsis and septic shock, those with low lactate clearance had poor prognosis, despite optimization of ScvO2. It is unknown if ScvO2 could still guide hemodynamic resuscitation after admission into ICU. The investigators perform a prospective observation study to see the correlation between ScvO2 and clinical outcome (including organ failure, disease severity, and survival) and the correlation between lactate and clinical outcome. Furthermore, if ScvO2 \>= 70% is still of prognostic significance in ICU, we will investigate the outcome in patients with high ScvO2 and high serum lactate levels, and to evaluate the clinical features of this patient population.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Adult patients who are admitted to medical intensive care units with severe sepsis or septic shock
Exclusion Criteria
- •Patients would be excluded if they have any one of the exclusion criteria, \*including pregnancy
- •presence of acute cerebral vascular attack
- •acute cardiogenic lung edema
- •status asthmatics
- •cardiac dysrhythmia as the primary diagnosis
- •massive gastrointestinal bleeding
- •epileptics
- •drug overdose
- •requirement of immediate surgery
- •hematologic malignancies
Outcomes
Primary Outcomes
28-day Mortality
Time Frame: 28 days
Record 28-day all-cause mortality in each population (low ScvO2, high ScvO2 and low serum lactate, high ScvO2 and high serum lactate)
Secondary Outcomes
- Severity of organ failure(1 week)
- In-Hospital Mortality(2 months)