Muge Aydogdu1, Gul Gursel. 1. Department of Pulmonary Critical Care Medicine, Gazi University School of Medicine, Besevler, Ankara, Turkey. maydogdu@gazi.edu.tr
Abstract
BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most frequent infections in intensive care units (ICUs), and nearly 50% of patients with VAP develop septic shock. Septic shock is an independent predictor for mortality in these patients. OBJECTIVE: To investigate the predictors for septic shock in VAP patients receiving appropriate antibiotic therapy. METHODS: Eighty-nine patients with microbiologically confirmed VAP who were receiving appropriate antibiotic therapy were included in the study. They were divided into two groups according to the existence of septic shock. Clinical, hematological, biochemical and microbiological characteristics were compared. RESULTS: Thirty-seven percent of the patients developed septic shock. Advanced age (OR 1.07, 95% CI 1.02-1.13, P = 0.009), lymphocytopenia (<1000/mm3) (OR 7.48, 95% CI 1.91-29, P = 0.004), high blood glucose levels >120 mg/dL (OR 4.75, 95% CI 1.38-16, P = 0.014), and increased clinical pulmonary infection scores (CPIS) (OR 1.64, 95% CI 1.16-2.33, P = 0.006) were identified as independent predictors for the development of septic shock. CONCLUSION: Some clinical parameters such as lymphocytopenia, blood glucose >120 mg/dL, increasing age, and CPIS can predict septic shock during VAP, but large randomized controlled studies are needed to confirm these results.
BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most frequent infections in intensive care units (ICUs), and nearly 50% of patients with VAP develop septic shock. Septic shock is an independent predictor for mortality in these patients. OBJECTIVE: To investigate the predictors for septic shock in VAP patients receiving appropriate antibiotic therapy. METHODS: Eighty-nine patients with microbiologically confirmed VAP who were receiving appropriate antibiotic therapy were included in the study. They were divided into two groups according to the existence of septic shock. Clinical, hematological, biochemical and microbiological characteristics were compared. RESULTS: Thirty-seven percent of the patients developed septic shock. Advanced age (OR 1.07, 95% CI 1.02-1.13, P = 0.009), lymphocytopenia (<1000/mm3) (OR 7.48, 95% CI 1.91-29, P = 0.004), high blood glucose levels >120 mg/dL (OR 4.75, 95% CI 1.38-16, P = 0.014), and increased clinical pulmonary infection scores (CPIS) (OR 1.64, 95% CI 1.16-2.33, P = 0.006) were identified as independent predictors for the development of septic shock. CONCLUSION: Some clinical parameters such as lymphocytopenia, blood glucose >120 mg/dL, increasing age, and CPIS can predict septic shock during VAP, but large randomized controlled studies are needed to confirm these results.
Authors: Fien H. R. De Winter; Bart 's Jongers; Kenny Bielen; Domenico Mancuso; Leen Timbermont; Christine Lammens; Vincent Van Averbeke; Jan Boddaert; Omar Ali; Jan Kluytmans; Alexey Ruzin; Surbhi Malhotra-Kumar; Philippe G Jorens; Herman Goossens; Samir Kumar-Singh Journal: Int J Mol Sci Date: 2019-10-12 Impact factor: 5.923
Authors: Ignacio Martin-Loeches; Adrian Ceccato; Marco Carbonara; Gianluigi Li Bassi; Pierluigi di Natale; Stefano Nogas; Otavio Ranzani; Carla Speziale; Tarek Senussi; Francesco Idone; Anna Motos; Miquel Ferrer; Antoni Torres Journal: Antibiotics (Basel) Date: 2021-06-30