Persistent sepsis-induced hypotension without hyperlactatemia: Is it really septic shock?

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dc.contributor.authorHernandez, Glenn
dc.contributor.authorCastro, Ricardo
dc.contributor.authorRomero, Carlos
dc.contributor.authorde la Hoz, Claudio
dc.contributor.authorAngulo, Daniela
dc.contributor.authorAranguiz, Ignacio
dc.contributor.authorLarrondo, Jorge
dc.contributor.authorBujes, Andres
dc.contributor.authorBruhn, Alejandro
dc.date.accessioned2024-01-10T13:16:11Z
dc.date.available2024-01-10T13:16:11Z
dc.date.issued2011
dc.description.abstractPurpose: The prognostic value of hyperlactatemia in septic shock is unquestionable. However, as current definitions do not include hyperlactatemia as a mandatory criterion, some hypotensive patients may be diagnosed as having septic shock despite exhibiting normolactatemia. The significance of persistent sepsis-induced hypotension without hyperlactatemia is unclear. Is it really septic shock? Our aim was to determine differences in outcome between patients diagnosed as having septic shock but exhibiting normal vs elevated lactate levels during evolution. We also explored the potential implications of including hyperlactatemia as an obligatory diagnostic criterion.
dc.description.abstractMethods: We performed retrospective analyses on a cohort of 302 septic shock patients.
dc.description.abstractResults: When we divided patients according to the presence of hyperlactatemia, 34% evolved without hyperlactatemia and exhibited a very low mortality risk ( 7.7% compared with 42.9% of those with hyperlactatemia). These patients also presented less severe organ dysfunctions and higher central venous O-2 saturation values, and required lower norepinephrine doses. The potential inclusion of hyperlactatemia in septic shock definition would reduce incidence in 34% but increase absolute mortality risk in 11%.
dc.description.abstractConclusions: Persistent sepsis-induced hypotension without hyperlactatemia may not constitute a real septic shock. Our results support the need to review the current definition of septic shock. Hyperlactatemia could represent an objective parameter worth to be explored as a potential diagnostic criterion for septic shock. (C) 2011 Elsevier Inc. All rights reserved.
dc.fechaingreso.objetodigital27-03-2024
dc.format.extent6 páginas
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.jcrc.2010.09.007
dc.identifier.eissn1557-8615
dc.identifier.issn0883-9441
dc.identifier.pubmedidMEDLINE:21126850
dc.identifier.urihttps://doi.org/10.1016/j.jcrc.2010.09.007
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/78565
dc.identifier.wosidWOS:000294608400028
dc.information.autorucMedicina;Angulo D ;S/I;149117
dc.information.autorucMedicina;Aranguiz I ;S/I;156257
dc.information.autorucMedicina;Bruhn A ;S/I;741
dc.information.autorucMedicina;Bujes A ;S/I;182475
dc.information.autorucMedicina;Castro R ;S/I;4537
dc.information.autorucMedicina;De la Hoz C ;S/I;175146
dc.information.autorucMedicina;Hernandez G ;S/I;98874
dc.information.autorucMedicina;Romero C ;S/I;92626
dc.issue.numero4
dc.language.isoen
dc.nota.accesocontenido parcial
dc.publisherW B SAUNDERS CO-ELSEVIER INC
dc.revistaJOURNAL OF CRITICAL CARE
dc.rightsacceso restringido
dc.subjectSeptic shock
dc.subjectLactate
dc.subjectCirculatory dysfunction
dc.subjectPerfusion
dc.subjectDefinition
dc.subjectEMERGENCY-DEPARTMENT PATIENTS
dc.subjectGOAL-DIRECTED THERAPY
dc.subjectNOREPINEPHRINE
dc.subjectMANAGEMENT
dc.subjectLACTATE
dc.subjectMORTALITY
dc.subjectHYDROCORTISONE
dc.subjectEPINEPHRINE
dc.subjectSURVIVAL
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titlePersistent sepsis-induced hypotension without hyperlactatemia: Is it really septic shock?
dc.typeartículo
dc.volumen26
sipa.codpersvinculados149117
sipa.codpersvinculados156257
sipa.codpersvinculados741
sipa.codpersvinculados182475
sipa.codpersvinculados4537
sipa.codpersvinculados175146
sipa.codpersvinculados98874
sipa.codpersvinculados92626
sipa.indexWOS
sipa.indexScopus
sipa.trazabilidadCarga SIPA;09-01-2024
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