scholarly journals Serum Lactate Albumin Ratio as a Predictor of Mortality in Severe Sepsis and Septic Shock at Tribhuwan University Teaching Hospital, Kathmandu

2017 ◽  
Vol 2 (2) ◽  
pp. 191-195 ◽  
Author(s):  
Sameer Thapa ◽  
PN Prasad ◽  
YM Shakya
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Serum Albumin ◽  
Emergency Room ◽  
Teaching Hospital ◽  
Serum Lactate ◽  
University Teaching ◽  
Health Evaluation ◽  
Albumin Ratio ◽  
Sepsis And Septic Shock

IntroductionSevere sepsis and septic shock, is a common cause of emergency room admission and is associated with high morbidity and mortality worldwide. This study inspects the prediction of mortality in severe sepsis and septic shock with increased lactate/albumin ratio.Objective The objective of the study was to predict the serum lactate albumin ratio as an indicator of mortality in severe sepsis and septic shock.MethodologyIt was a hospital based cross sectional study done at Tribhuvan University Teaching Hospital, Kathmandu from November 2015 to October 2016. The consent was taken from patients. Acute Physiology and Chronic Health Evaluation II score, serum lactate and serum albumin levels on first day of arrival in emergency room were calculated. Patients were classified as severe sepsis and septic shock and treated according to Surviving Sepsis Campaign 2012 guideline. The patient were follow up at 28 day, The associations of 28-day outcome with Acute Physiology and Chronic Health Evaluation II score, serum lactate value, serum albumin value and serum lactate albumin ratio value were derived.ResultsOut of total 240 severe sepsis and septic shock patients it is found that increased serum lactate/albumin ratio was an independent predictor of the mortality with cut off value of 0.07. Furthermore serum lactate albumin ratio shows strong correlation with APACHE 2 score in predicting mortality in severe sepsis and septic shock.ConclusionIncreased lactate/albumin ratio predicts mortality in patients with severe sepsis and septic shock.  Birat Journal of Health Sciences  Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 191-195

Base Deficit as a Predictor of Mortality in Sepsis and Septic Shock

2019 ◽  
Vol 2 (2) ◽  
pp. 81-88
Author(s):  
Laxman Bhusal ◽  
Pratap Narayan Prasad ◽  
Yogendra Man Shakya ◽  
Ramesh Prasad Acharya
Keyword(s):  
Septic Shock ◽  
Emergency Room ◽  
Sofa Score ◽  
Base Deficit ◽  
Chronic Health Evaluation ◽  
Apache Ii ◽  
University Teaching ◽  
Health Evaluation ◽  
Chronic Health ◽  
Sepsis And Septic Shock

 Introduction: Sepsis is a common problem encountered in emergency room which needs to be intervened early. It is always difficult to have quick prognostic marker of sepsis in busy emergency. So this study was conducted to determine whether base deficit can be used as an indicator of mortality among septic patients in emergency room setup like ours. Methods: It was a hospital based descriptive cross sectional study done at Tribhuvan University Teaching Hospital, Kathmandu from March 2018 to December 2018. Acute physiology and chronic health Evaluation II score (APACHE II), Base deficit, Sequential Organ Failure Assessment (SOFA) score on first day of arrival in emergency room was calculated. The association of 28-day outcome with acute physiology and chronic Health Evaluation II score, Base deficit value and SOFA score were derived. Results: Out of 229 patients with septic shock 62 died (27%) and among 71 patients without septic shock, 12 died (16.9%).Overall mortality was 24.66 % (n= 74).The area under the ROC curve for Base deficit(0.864;95% C.I.=0.822-0.906), APACHE II (0.782; 95% C.I=0.718-0.848, SOFA (0.689;95% C.I=0.620-0.757) were greater than 0.7 except for SOFA which signifies these test to have fair efficacy to predict mortality. Conclusions: High base deficit value predicts mortality in patients with sepsis and septic shock. The base deficit could be used as an alternate marker to predict mortality in septic patient. We recommend for large multicenter study with randomization so that the findings can be applied to general population and of different geographical situations.

scholarly journals Is Presepsin a Reliable Marker of Sepsis Diagnosis in Pediatric Intensive Care Unit?

2020 ◽  
Vol 8 (B) ◽  
pp. 66-70
Author(s):  
Hebat-Allah Algebaly ◽  
Hala M. Fouad ◽  
Maha M. Elkholy ◽  
Sally K. Ibrahim ◽  
Nermin M. Riad
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Consensus Conference ◽  
University Teaching ◽  
Control Group ◽  
Healthy Children ◽  
International Consensus ◽  
Critical Patients ◽  
Sepsis And Septic Shock

BACKGROUND: Sepsis is a major challenge in emergency departments and intensive care units (ICUs). Sepsis also mimics or interacts with many other disorders causing high mortality and morbidity. There is no accurate biomarker or test to diagnose or predict sepsis. The treatment of sepsis is often based on the clinician’s experience. AIM: We conducted this study to analyze the serum level of presepsin in pediatric critical patients with SIRS, sepsis, severe sepsis, and septic shock. METHODS: The study included 58 children, 32 septic pediatric patients admitted to the Pediatric ICU (PICU) of Cairo University Teaching Hospital and 26 healthy children who served as a control group. The aim was to estimate the diagnostic accuracy of presepsin in predicting sepsis in PICU. We classified the patients into systemic inflammatory response syndrome, sepsis, severe sepsis, and septic shock according to the international consensus conference criteria. RESULTS: In our study, we detected a positive correlation between C-reactive protein and presepsin levels at day 1 and day 3 of admission and a negative correlation between hemoglobin and presepsin levels at day 1. However, we found no difference in the serum presepsin between the children who had sepsis and the healthy ones (at day 1 [p = 0.430) and at day 3 [p = 0.845]). We also found that serum levels of presepsin were not significantly increased with the increasing severity of sepsis despite the higher median values with increasing sepsis severity. CONCLUSIONS: It was noted that presepsin levels increased in anemic critical patients, whereas presepsin had no role in differentiating the septic critical patients from healthy children. However, its level increased with increasing severity of sepsis grade.

Diagnostic Validity of Ratio between Differences of Central Venous to Arterial CO2 and Arterial to Central Venous O2 Content in Diagnosis of Anaerobic Metabolism among Septic Patients

2021 ◽  
Vol 8 (1) ◽  
pp. 34-38
Author(s):  
Subroto Kumar Sarker ◽  
Umme Kulsum Choudhury ◽  
Mohammad Mohsin ◽  
Subrata Kumar Mondal ◽  
Muslema Begum
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Intensive Care ◽  
Anaerobic Metabolism ◽  
Venous Blood ◽  
Blood Gases ◽  
Serum Lactate ◽  
Central Venous ◽  
College Hospital ◽  
Sepsis And Septic Shock

Background: Detection of anaerobic metabolism is very crucial for the management of the septic patients. Objective: The purpose of the present study was to validate the ratio between differences of central venous to arterial CO2 and arterial to central venous O2 content in diagnosis of anaerobic metabolism among septic patients. Methodology: This prospective observational study was conducted in the Intensive Care Unit of the department of Anaesthesia Analgesia, Palliative and Intensive Care Medicine at Dhaka Medical College Hospital, Dhaka, Bangladesh from January 2016 to December 2016. All patients admitted to ICU with the features of severe sepsis and septic shock according to SSC guidelines with the age of more than or equal to 18 years in both sexes were included in this study. The arterial and central venous blood gases were measure simultaneously. At the same time serum lactate was measured. Result: Among the 69 patients, 31(44.9%) were of severe sepsis and 38(55%) were of septic shock patients. In the severe sepsis and septic shock patients the mean P(v-a)CO2/C(a-v)O2 is 1.39±0.41 and 1.11±0.40 respectively. Serum lactate in case of severe sepsis and septic shock patients is 2.85±1.40 and 3.85±1.04 respectively. The ROC analysis showed an area under curve 0.89 and P(v-a)CO2/C(a-v)O2 ratio cutoff value of 1.21 showed sensitivity 0.84 and specificity 0.94. Conclusion: The P(v-a)CO2/C(a-v)O2  ratio is also a another marker of global anaerobic metabolism and it would be used for diagnosis as well as management of septic patient.  Journal of Current and Advance Medical Research, January 2021;8(1):34-38

scholarly journals Evolutive standard base excess and serum lactate level in severe sepsis and septic shock patients resuscitated with early goal-directed therapy: still outcome markers?

Clinics ◽  
2006 ◽  
Vol 61 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Marcelo Park ◽  
Luciano Cesar Pontes Azevedo ◽  
Alexandre Toledo Maciel ◽  
Vladimir Ribeiro Pizzo ◽  
Danilo Teixeira Noritomi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Base Excess ◽  
Serum Lactate ◽  
Serum Lactate Level ◽  
Goal Directed Therapy ◽  
Early Goal Directed Therapy ◽  
Standard Base Excess ◽  
Standard Base ◽  
Sepsis And Septic Shock

scholarly journals STUDY OF SERUM LACTATE LEVELS IN PATIENTS WITH SEPSIS ON THE BASIS OF SURVIVAL AND NON-SURVIVAL

2021 ◽  
pp. 8-10
Author(s):  
Anisha Tanwar ◽  
Bushra Fiza ◽  
Bhupesh Medatwal ◽  
Rubal Singh ◽  
Maheep Sinha
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Lactic Acid ◽  
Survival Rate ◽  
Lactate Concentration ◽  
Serum Lactate ◽  
Mortality Prediction ◽  
P Value ◽  
Lactate Levels ◽  
Sepsis And Septic Shock

INTRODUCTION:- Sepsis is a leading cause of morbidity and mortality internationally Early spotting and . interventions are essential to ensure better patient's outcome. Lactate concentration in septic patients is of particular prognostic value in predicting septic shock and mortality. AIM:- The present study was intended to evaluate the serum Lactate levels on the basis of severity rate in patients suffering of sepsis, severe sepsis and septic shock. MATERIAL & METHOD:- 100 patients diagnosed for sepsis were enrolled for the study and they were grouped as sepsis (n=30), severe sepsis (n=37)and septic shock (n=33). On the basis of survival rate serum Lactate levels in patients with sepsis were estimated in all the 3 categories of subjects according to the inclusion criteria. A p-Value of ≤0.05 were considered as statistically significant. RESULT:- In the present study when the lactate levels were evaluated among all the three categories, it was observed that the Lactate levels were found to be statistically significant (p-value <0.0001). Lactic acid evaluated on the basis of survival rate was also found to be statistically significant with the p-Value 0.015. CONCLUSION:- Lactic acid could be utilized as a reliable marker to assess prognosis at the initial phase of presentation because its initial evaluation shows good predictability in mortality prediction in sepsis patients.

Correlation of lactate/albumin ratio level to organ failure and mortality in severe sepsis and septic shock

2015 ◽  
Vol 30 (2) ◽  
pp. 271-275 ◽  
Author(s):  
Biao Wang ◽  
Gang Chen ◽  
Yifei Cao ◽  
Jiping Xue ◽  
Jia Li ◽  
...  
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Organ Failure ◽  
Albumin Ratio ◽  
Sepsis And Septic Shock

scholarly journals Effect of levosimendan on mortality in severe sepsis and septic shock: a meta-analysis of randomised trials

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019338 ◽  
Author(s):  
Wei Chang ◽  
Jian-Feng Xie ◽  
Jing-Yuan Xu ◽  
Yi Yang
Keyword(s):  
Septic Shock ◽  
Severe Sepsis ◽  
Meta Analysis ◽  
Serum Lactate ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Current Evidence ◽  
Randomised Trials ◽  
Fluid Infusion ◽  
Sepsis And Septic Shock

ObjectiveWe aim to synthesise up-to-date randomised trials to investigate the effects of levosimendan on mortality and clinical outcomes in severe sepsis and septic shock.MethodsA collection of databases including PubMed, EMBASE, Cochrane Central Register and Web of Science were searched updated to August 2017. Randomised trials were included when they pertain to the use of levosimendan in severe sepsis or septic shock compared with any category of inotropes, or as an adjunct to standard therapy with mortality reported. The primary outcome was mortality, and the secondary outcomes were clinical performances including serum lactate, cardiac function, vasopressor requirement and fluid infusion.ResultsA total of 10 studies with 1036 patients were included in this meta-analysis. The results revealed that levosimendan could not reduce mortality significantly in severe sepsis and septic shock (OR 0.89, 95% CI 0.69 to 1.16, P=0.39). Levosimendan use could reduce serum lactate more effectively, and enhance cardiac contractibility with increased cardiac index and left ventricular ejection fraction. However, its use could also increase fluid infusion but not reduce norepinephrine dose. No significant benefit in mortality could be observed of levosimendan versus dobutamine use, or in patients with proven cardiac dysfunction.ConclusionsCurrent evidence is not sufficient to support levosimendan as superior to dobutamine or as an optimal adjunct in severe sepsis and septic shock. More large-scale randomised trials are necessary to validate levosimendan use in sepsis.

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