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Early Recognition and Treatment of Sepsis After the Addition of Lactate to the Laboratory's Critical Result Call List.
Kuttab, Hani I; Sterk, Ethan; Rech, Megan A; Nghiem, Trac; Bahar, Burak; Kahn, Stephen.
Afiliación
  • Kuttab HI; 1 Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA.
  • Sterk E; 1 Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA.
  • Rech MA; 2 Department of Emergency Medicine, Loyola University Medical Center, Maywood, IL, USA.
  • Nghiem T; 2 Department of Emergency Medicine, Loyola University Medical Center, Maywood, IL, USA.
  • Bahar B; 3 Department of Pharmacy, Loyola University Medical Center, Maywood, IL, USA.
  • Kahn S; 1 Stritch School of Medicine, Loyola University Medical Center, Maywood, IL, USA.
J Intensive Care Med ; 33(2): 111-115, 2018 Feb.
Article en En | MEDLINE | ID: mdl-27619691
PURPOSE: Screening of patients with sepsis is needed to increase recognition and allow for earlier interventions. There is no consensus on whether the addition of lactate to the critical result laboratory's call list should be a standard practice. MATERIALS AND METHODS: This was a retrospective cohort study that compared management and outcomes of patients with sepsis having lactate ≥4 mmol/L before (group 1) and after (group 2) the addition of a critical result threshold of lactate of ≥4 mmol/L to the critical result laboratory's call list and its effects on time to antibiotics and intravenous fluids (IVFs). RESULTS: One hundred twenty-one patients were included. Lactate was higher in group 1 (7.0 ± 4.3 vs 5.6 ± 2.0, P = 0.03). More patients in group 2 received hydrocortisone (1.9% vs 22.4%, P = .001). Hospital mortality, 30-day mortality, and 90-day mortality were significantly lower in group 2 (59.3% vs 32.8%, P = .003; 68.5% vs 37.3%, P ≤ .001; 68.5% vs 41.8%, P = .002). There were no significant differences in total volume of IVFs (2400.8 ± 1720.0 vs 2483.7 ± 2155.7, P = 0.83), time to start IVFs (184.0 ± 283.2 vs 115.6 ± 190.5, P = 0.27), or antibiotics (184.8 ± 187.1 vs 133.7 ± 137.4, P = 0.16). CONCLUSION: Addition of lactate to the critical result laboratory's call list did not lead to a statistically significant improvement in time to IVFs or antibiotics, although the average time to antibiotics and IVFs decreased by 51.1 and 68.4 minutes, respectively. Hospital mortality, 30-day mortality, and 90-day mortality were lower in group 2, which may be, in part, due to increased recognition of severe sepsis by critical result notification and earlier intervention.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Política Organizacional / Mortalidad Hospitalaria / Sepsis / Ácido Láctico / Tiempo de Tratamiento Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Intensive Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Política Organizacional / Mortalidad Hospitalaria / Sepsis / Ácido Láctico / Tiempo de Tratamiento Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Intensive Care Med Asunto de la revista: TERAPIA INTENSIVA Año: 2018 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos