Predictive factors for septic shock in patients with ventilator-associated pneumonia.

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.

journal_name

South Med J

journal_title

Southern medical journal

authors

Aydogdu M,Gursel G

doi

10.1097/SMJ.0b013e3181827891

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

1222-6

issue

12

eissn

0038-4348

issn

1541-8243

journal_volume

101

pub_type

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