Document Detail


Sepsis syndrome: a valid clinical entity. Methylprednisolone Severe Sepsis Study Group.
MedLine Citation:
PMID:  2651003     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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)
Authors:
R C Bone; C J Fisher; T P Clemmer; G J Slotman; C A Metz; R A Balk
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  17     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1989 May 
Date Detail:
Created Date:  1989-06-07     Completed Date:  1989-06-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  389-93     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
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MeSH Terms
Descriptor/Qualifier:
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:
2921-57-5/Methylprednisolone Hemisuccinate; 83-43-2/Methylprednisolone
Comments/Corrections
Comment In:
Crit Care Med. 1990 Sep;18(9):1048   [PMID:  2394110 ]

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