Effect of the Immunoglobulin G-A-M Treatment on Hepatic Functions and Mortality rates in Patients with Septic Shock
Öz
Background: In this study, we aimed to explore the effects of conventional sepsis treatment, including classical antibiotherapy and Immunoglubin (Ig) G-A-M combination (Pentaglobin®), on liver function tests and mortality rate in patients with septic shock.
Methods: All patients diagnosed with septic shock and treated with Pentaglobin® in the adult intensive care unit of Suleyman Demirel University Practice and Research Hospital between 2005-2013 were retrospectively examined. Demographic properties, age, gender, intensive care treatment duration, general exitus day, the death rate in the first 28 days, general death-survival period, 28th-day death rate, mortality rate, and diagnosis of cases were recorded.
Results: At the end of the treatment, it was found that 35 of the cases died, and 35 were transferred to various clinical wards. The overall mortality rate was calculated as 50% from the obtained data. It was found that 40 patients survived in the first 28 dayswhile 30 patients died. In this study, it was observed that Pentaglobin® treatment had no statistically significant impact on ASTALT-Albumin values and mortality rates.
Conclusions: However, early diagnosis of sepsis, early initiation of antibiothearpy, early source control, and timely initiation of appropriate fluid therapy play a key role in the succsess of sepsis treatment. For this purpose, as emphasized in the sepsis 3 guideline, we think that raising awareness by physicians and practitioners in the early diagnosis of sepsis is the most important step in the treatment of this clinical condition.
Anahtar Kelimeler
Kaynakça
- 1. Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801-10.
- 2. Gyawali B, Ramakrishna K, Dhamoon AS. Sepsis: The evolution in definition, pathophysiology, and management. SAGE Open Med. 2019;7:2050312119835043.
- 3. Bugiantella W, Rondelli F, Boni M, Stella P, Polistena A, Sanguinetti A, et al. Necrotizing pancreatitis: A review of the interventions. Int J Surg. 2016;28 Suppl 1:S163-71.
- 4. Eastridge BJ, Holcomb JB, Shackelford S. Outcomes of traumatic hemorrhagic shock and the epidemiology of preventable death from injury. Transfusion. 2019;59(S2):1423-1428.
- 5. van Breugel JMM, Niemeyer MJS, Houwert RM, Groenwold RHH, Leenen LPH, van Wessem KJP. Global changes in mortality rates in polytrauma patients admitted to the ICU-a systematic review. World J Emerg Surg. 2020;15(1):55.
- 6. Webb JG, Sanborn TA, Sleeper LA, Carere RG, Buller CE, Slater JN, et al. SHOCK Investigators. Percutaneous coronary intervention for cardiogenic shock in the SHOCK Trial Registry. Am Heart J. 2001;141(6):964-70.
- 7. Rodríguez-Acelas AL, de Abreu Almeida M, Engelman B, Cañon- Montañez W. Risk factors for health care-associated infection in hospitalized adults: Systematic review and meta-analysis. Am J Infect Control. 2017;45(12):e149-e156.
- 8. SepNet Critical Care Trials Group. Incidence of severe sepsis and septicshock in German intensive care units: the prospective, multicentre INSEP study. Intensive Care Med. 2016;42(12):1980-1989.
- 9. Karlsson S, Varpula M, Ruokonen E, Pettilä V, Parviainen I, Ala-KokkoTI, et al. Incidence, treatment, and outcome of severe sepsis in ICUtreated adults in Finland: the Finnsepsis study. Intensive Care Med. 2007;33(3):435-43.
- 10. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA. 2014;311(13):1308-16.