Effect of corticosteroids on arginine vasopressin–containing vasopressor therapy for septic shock: a case control study

Background The use of ≥30 mL/Kg fluid bolus in congestive heart failure (CHF) patients presenting with severe sepsis or septic shock remained controversial due to the paucity of data. Methods The retrospective case-control study included 671 adult patients who presented to the emergency department of a tertiary care hospital from January 01, 2017 to December 31, 2019 with severe sepsis or septic shock. Patients were categorized into the CHF group and the non-CHF group. The primary outcome was to evaluate the compliance with ≥30 mL/Kg fluid bolus within 6 hours of presentation. The comparison of baseline characteristics and secondary outcomes were done between the groups who received ≥30 mL/Kg fluid bolus. For the subgroup analysis of the CHF group, it was divided based on if they received ≥30 mL/Kg fluid bolus or not, and comparison was done for baseline characteristics and secondary outcomes. Univariate and multivariable analyses were performed to explore the differences between the groups for in-hospital mortality and mechanical ventilation. Results The use of ≥30 mL/Kg fluid bolus was low in both the CHF and non-CHF groups [39% vs. 66% (p<0.05)]. Mortality was higher in the CHF group [33% vs 18% (p<0.05)]. Multivariable analysis revealed that the use of ≥30 mL/Kg fluid bolus decreased the chances of mortality by 12% [OR 0.88, 95% CI 0.82–0.95 (p<0.05)]. The use of ≥30 mL/Kg fluid bolus did not increase the odds of mechanical ventilation [OR 0.99, 95% CI 0.93–1.05 (p = 0.78)]. In subgroup analysis, the use of ≥30 mL/Kg fluid bolus decreased the chances of mortality by 5% [OR 0.95, 95% CI 0.90–0.99, (p<0.05)] and did not increase the odds of mechanical ventilation. The presence of the low ejection fraction did not influence the chance of getting fluid bolus. Conclusion The use of ≥30 mL/Kg fluid bolus seems to confer protection against in-hospital mortality and is not associated with increased chances of mechanical ventilation in heart failure patients presenting with severe sepsis or septic shock.

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Effects of levosimendan on renal function in septic shock: a case–control study

Critical Care ◽

10.1186/cc7334 ◽

2009 ◽

Vol 13 (Suppl 1) ◽

pp. P170 ◽

Cited By ~ 2

Author(s):

A Morelli ◽

C Etmer ◽

S Rehberg ◽

A Orecchioni ◽

N Cannuovacciuolo ◽

...

Keyword(s):

Septic Shock ◽

Renal Function ◽

Case Control Study ◽

Case Control ◽

Control Study

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Speckle tracking echocardiography in patients with septic shock: a case control study (SPECKSS)

Critical Care ◽

10.1186/s13054-016-1327-0 ◽

2016 ◽

Vol 20 (1) ◽

Cited By ~ 31

Author(s):

Pauline Yeung Ng ◽

Wai Ching Sin ◽

Andrew Kei-Yan Ng ◽

Wai Ming Chan

Keyword(s):

Septic Shock ◽

Speckle Tracking ◽

Case Control Study ◽

Speckle Tracking Echocardiography ◽

Case Control ◽

Control Study

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Association between procalcitonin and acute kidney injury in patients with septic shock: A case-control study

10.21203/rs.2.22052/v1 ◽

2020 ◽

Author(s):

Ming Wu ◽

Guang Fu ◽

Hao-li Li ◽

Hai-chao Zhan ◽

Jun-fu Lu ◽

...

Keyword(s):

Septic Shock ◽

Acute Kidney Injury ◽

Case Control Study ◽

Piecewise Linear ◽

Kidney Injury ◽

Case Control ◽

Primary Analysis ◽

Female Patients ◽

The Relationship ◽

Control Study

Abstract Objective This study aims to assess the relationship between serum procalcitonin (PCT) and acute kidney injury (AKI) induced by sepsis shock.Methods A case-control study was designed which included patients that admitted in intensive care unit (ICU) between January 2015 and October 2018. The worst values of biochemical parameters in the first 48 hours from septic shock admission to ICU were evaluated. According to KDIGO guideline, these patients were divided into AKI and non-AKI groups.Results Of 1631 patients screened, 157 patients were included in the primary analysis in which 84 (53.5%) patients with AKI. Multiple logistic regression results showed that PCT (OR=1.017, 95% CI 1.009- 1.025, P<0.001) was associated with AKI induced by septic shock. The ROC analysis showed that the cutoff point for PCT to predict AKI development was 14 ng/ml, and with a sensitivity 63%, specificity 67%. Specifically, in multivariate piecewise linear regression, the occurrence of AKI decreased with the elevation of PCT when PCT was between 25mol/L and 120 mol/L (OR 0.963, 95% CI 0.929-0.999; P= 0.042). The AKI increased with the elevation of PCT when PCT was either less than 25mol/L (OR 1.077, 95% CI 1.022-1.136; P= 0.006) or more than 120mol/L (OR 1.042, 95% CI 1.009-1.076; P= 0.013). Moreover, the PCT level was significant higher in AKI group only in female patients with age under 75(P=0.001).Conclusions Our data revealed a nonlinear relationship between PCT in 48 hours admission to ICU and AKI in septic shock patients and PCT could be used as a biomarker of AKI only in female patients under 75 years with sepsis shock.

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Microcirculatory, Endothelial and Inflammatory Responses in Critically Ill Patients with COVID-19 Are Distinct from Those Seen in Septic Shock: A Case Control Study

SSRN Electronic Journal ◽

10.2139/ssrn.3627342 ◽

2020 ◽

Author(s):

Sam Hutchings ◽

James Watchorn ◽

Francesca Trovato ◽

Salvatore Napoli ◽

Salma F Mujib ◽

...

Keyword(s):

Septic Shock ◽

Critically Ill ◽

Critically Ill Patients ◽

Case Control Study ◽

Inflammatory Responses ◽

Case Control ◽

Control Study

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Adjunctive therapy with vitamin c and thiamine in patients treated with steroids for refractory septic shock: A propensity matched before-after, case-control study

Journal of Critical Care ◽

10.1016/j.jcrc.2020.04.014 ◽

2020 ◽

Vol 59 ◽

pp. 37-41 ◽

Cited By ~ 1

Author(s):

Irene Coloretti ◽

Emanuela Biagioni ◽

Sophie Venturelli ◽

Elena Munari ◽

Martina Tosi ◽

...

Keyword(s):

Septic Shock ◽

Vitamin C ◽

Adjunctive Therapy ◽

Case Control Study ◽

Case Control ◽

Refractory Septic Shock ◽

Control Study

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Thiamine Status in Children with Septic Shock from a Developing Country: A Prospective Case–Control Study

Journal of Tropical Pediatrics ◽

10.1093/tropej/fmaa107 ◽

2020 ◽

Author(s):

Kumar Manish Raj ◽

Arun K Baranwal ◽

Savita Verma Attri ◽

Muralidharan Jayashree ◽

Praveen Kumar-M ◽

...

Keyword(s):

Septic Shock ◽

Developing Country ◽

Case Control Study ◽

Case Control ◽

Healthy Children ◽

Post Discharge ◽

Severe Deficiency ◽

Control Study ◽

Prospective Case Control Study ◽

Apparently Healthy

Abstract Objective Mitochondrial dysfunction is central to sepsis-induced multi-organ dysfunction. Thiamine deficiency may contribute to mitochondrial dysfunction and thus high mortality. Study was planned to assess thiamine status in children with septic shock in comparison to healthy controls from a developing country and to study the effect of thiamine levels on its outcome. Methods A prospective case-control study (April 2017 to May 2018) enrolling consecutive children with septic shock as ‘cases’ (n = 76), their healthy siblings (n = 51) and apparently healthy children from immunization clinic (n = 35) as ‘controls’. Whole blood total thiamine (WBTT) level was measured on days 1, 10 and 1-month post-discharge. Outcome parameters were acute care area free days on days 14 and 28, and mortality. Results WBTT [nMol/l; median (interquartile range, IQR)] was significantly lower on day 1 in cases compared with sibling controls [23.1 (21.8–26.3) vs. 36.9 (33.6–40.5); p < 0.001]. It fell further on day 10 [20.8 (18.1–21.1); p < 0.02]. Levels rose significantly 1-month post-discharge [35.5 (31.2–36.6)] and became comparable to sibling controls (p = 0.4). Immunization clinic controls also had lower WBTT [42.3 (40.1–45.9)], but was significantly higher than sibling controls and cases at 1-month post-discharge (p < 0.001). Survivors and non-survivors of septic shock were similar. WBTT levels did not correlate with any of the severity indicators of septic shock or its outcomes. Conclusions WBTT was significantly low in all children, and fell further during septic shock. Observed severe deficiency might have precluded any further association of thiamine levels with severity of septic shock and its outcome. Data obtained may inform trials on metabolic resuscitation in paediatric septic shock in developing countries. Lay summary Thiamine deficiency may contribute to high mortality in paediatric septic shock as thiamine is an essential factor for functioning of mitochondria, the powerhouse of the cells. This prospective case–control study was conducted to assess thiamine status in children with septic shock in comparison with healthy controls in a developing country. Consecutive children with fluid-refractory septic shock were enrolled as ‘cases’. Their apparently healthy siblings, and apparently healthy children from immunization clinic, were enrolled as ‘controls’. The whole blood total thiamine (WBTT) level was measured on days 1, 10 and 1 month after hospital discharge. Seventy-six children were enrolled as cases, 51 children as sibling controls and 35 children as immunization clinic controls. WBTT was significantly lower on day 1 in cases as compared with their sibling controls. It fell further on day 10. The level rose significantly after a month of discharge and became comparable to sibling controls. Immunization clinic controls also had lower WBTT but was significantly higher compared with sibling controls and cases at 1-month post-discharge. Survivors and non-survivors of septic shock had similar WBTT levels. Observed severe deficiency might have precluded any further association of thiamine levels with septic shock outcome.

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