| Sepsis syndrome: a valid clinical entity. Methylprednisolone Severe Sepsis Study Group. | |
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MedLine Citation:
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PMID: 2651003 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The sepsis syndrome represents a systemic response to infection and is defined as hypothermia (temperature less than 96 degrees F) or hyperthermia (greater than 101 degrees F), tachycardia (greater than 90 beat/min), tachypnea (greater than 20 breath/min), clinical evidence of an infection site and with at least one end-organ demonstrating inadequate perfusion or dysfunction expressed as poor or altered cerebral function, hypoxemia (PaO2 less than 75 torr), elevated plasma lactate, or oliguria (urine output less than 30 ml/h or 0.5 ml/kg body weight.h without corrective therapy). One hundred ninety-one patients with the sepsis syndrome were evaluated prospectively and comprised the placebo group of a multicenter trial of methylprednisolone in sepsis syndrome and septic shock. Forty-five percent of the patients were found to be bacteremic. Thirty-six percent of the patients were in septic shock (sepsis syndrome plus a systolic BP less than 90 mm Hg or a decrease from baseline in systolic BP greater than 40 mm Hg) on study entry. An additional 23% of the patients developed shock after admission with 70% doing so within 24 h of study entry. Shock reversal occurred with a 73% frequency. Twenty-five percent of the patients developed the adult respiratory distress syndrome (ARDS). Mortality for the patients with sepsis syndrome who did not develop shock was 13%. Mortality for the groups of patients with shock on admission and shock postadmission was 27.5% and 43.2%, respectively. Forty-seven percent of the bacteremic patients developed shock after study admission compared to 29.6% of the nonbacteremic patients (p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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R C Bone; C J Fisher; T P Clemmer; G J Slotman; C A Metz; R A Balk |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 17 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 1989 May |
Date Detail:
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Created Date: 1989-06-07 Completed Date: 1989-06-07 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 389-93 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Body Temperature Double-Blind Method Hemodynamics Humans Hypotension / diagnosis Methylprednisolone / analogs & derivatives* Methylprednisolone Hemisuccinate / therapeutic use* Middle Aged Prospective Studies Random Allocation Respiratory Distress Syndrome, Adult / prevention & control* Sepsis / diagnosis*, drug therapy, mortality Shock, Septic / mortality, prevention & control* Syndrome |
| Chemical | |
Reg. No./Substance:
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2921-57-5/Methylprednisolone Hemisuccinate; 83-43-2/Methylprednisolone |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 1990 Sep;18(9):1048
[PMID:
2394110
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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