World Journal of Emergency Medicine ›› 2020, Vol. 11 ›› Issue (4): 216-222.doi: 10.5847/wjem.j.1920-8642.2020.04.003
Special Issue: Sepsis
• Original Article • Previous Articles Next Articles
Yu-ming Wang1, Yan-jun Zheng1, Ying Chen1, Yun-chuan Huang1, Wei-wei Chen1, Ran Ji1, Li-li Xu1, Zhi-tao Yang1, Hui-qiu Sheng1, Hong-ping Qu2, En-qiang Mao1(), Er-zhen Chen1()
Received:
2019-11-01
Accepted:
2020-05-20
Online:
2020-10-01
Published:
2020-10-01
Contact:
En-qiang Mao,Er-zhen Chen
E-mail:maoeq@yeah.net;chenerzhen@hotmail.com
Yu-ming Wang, Yan-jun Zheng, Ying Chen, Yun-chuan Huang, Wei-wei Chen, Ran Ji, Li-li Xu, Zhi-tao Yang, Hui-qiu Sheng, Hong-ping Qu, En-qiang Mao, Er-zhen Chen. Effects of fluid balance on prognosis of acute respiratory distress syndrome patients secondary to sepsis[J]. World Journal of Emergency Medicine, 2020, 11(4): 216-222.
Add to citation manager EndNote|Ris|BibTeX
URL: http://wjem.com.cn//EN/10.5847/wjem.j.1920-8642.2020.04.003
Table 1
Characteristics of sepsis patients with or without ARDS
Parameters | Patients (n=322) | No ARDS (n=238) | ARDS (n=84) | P-value |
---|---|---|---|---|
Sex Male Female Age (years) BMI (kg/m2) Sepsis category Septic shock Sepsis Mortality Origin EICU Medical emergency ward Trauma surgery ward Other Comorbidities Hypertension Diabetes Arrhythmia CHD CKD Cerebral infarction Source of sepsis Gut Lung Urinary tract Abdomen Skin Blood Not found Other SOFA score APACHE II Creatinine (μmol/L) PaO2/FiO2 (mmHg) Duration of hospital stay (days) Duration of ICU stay (days) Duration of mechanical ventilation (days) | 195 (60.6) 127 (39.4) 62 (46-73) 23.68±3.80 192 (59.6) 130 (40.4) 72 (22.4) 219 (68.0) 67 (20.8) 9 (2.8) 27 (8.4) 138 (42.9) 78 (24.2) 19 (5.9) 26 (8.1) 5 (1.6) 12 (3.7) 35 (10.9) 181 (56.2) 18 (5.6) 48 (14.9) 9 (2.8) 8 (2.5) 13 (4.0) 10 (3.1) 6 (4-8) 11±5 167.4±217.3 231.9±94.8 21 (13-34) 14 (7-25) 0 (0-8) | 142 (59.7) 96 (40.3) 63 (43-73) 23.65±3.81 139 (58.4) 99 (41.6) 37 (15.5) 156 (65.5) 58 (24.4) 6 (2.5) 18 (7.6) 95 (39.9) 52 (21.8) 13 (5.5) 20 (8.4) 8 (3.4) 4 (1.7) 28 (11.8) 120 (50.4) 18 (7.6) 39 (16.3) 9 (3.8) 6 (2.5) 10 (4.2) 8 (3.4) 5 (3-7) 10±5 163.3±223.5 255.0±91.2 21 (14-33) 14 (7-24) 0 (0-0) | 53 (63.1) 31 (36.9) 62 (50-70) 23.71±3.83 53 (63.1) 31 (36.9) 35 (41.7) 63 (75.0) 9 (10.7) 3 (3.6) 9 (10.7) 43 (51.2) 26 (31.0) 6 (7.1) 6 (7.1) 4 (4.8) 1 (1.2) 7 (8.3) 61 (72.6) 0 (0) 9 (10.7) 0 (0) 2 (2.4) 3 (3.6) 2 (2.4) 8 (4-8) 14±5 178.8±198.7 166.4±71.0 23 (11-45) 15 (7-31) 11 (6-24) | 0.580 0.900 0.892 0.451 <0.001 0.110 0.008 0.907 0.370 0.322 0.094 0.574 0.715 0.804 1.000 0.385 <0.001 0.001 0.210 0.019 1.000 1.000 0.937 <0.001 <0.001 0.582 <0.001 0.737 0.227 <0.001 |
Table 2
Characteristics of survivors and non-survivors
Parameters | Survivors (n=49) | Non-survivors (n=35) | P-value |
---|---|---|---|
Sex Male Female Age (years) BMI (kg/m2) Sepsis category Septic shock Sepsis Origin EICU Medical emergency ward Trauma surgery ward Other Comorbidities Hypertension Diabetes Arrhythmia CHD CKD Cerebral infarction Source of sepsis Gut Lung Abdomen Other Not found SOFA score APACHE II score PEEP (cmH2O) Tidal volume (mL/kg) PaO2/FiO2 (mmHg) Creatinine (μmol/L) Duration of hospital stay (days) Duration of ICU stay (days) Duration of mechanical ventilation (days) | 32 (65.3) 17 (34.7) 64 (51-70) 24.30±3.50 29 (59.2) 20 (40.8) 33 (67.3) 7 (14.3) 3 (6.1) 6 (12.3) 29 (59.2) 15 (30.6) 4 (8.2) 6 (12.2) 4 (8.2) 1 (2.0) 5 (10.2) 37 (75.5) 4 (8.2) 1 (2.0) 2 (4.1) 7 (6-9) 13±5 6 (5-8) 8.6±2.1 175.1±71.5 148.2±161.3 32 (18-66) 19 (7-31) 12 (7-25) | 21 (60.0) 14 (40.0) 57 (44-70) 22.89±4.10 24 (68.6) 11 (31.4) 30 (85.7) 2 (5.7) 0 (0) 3 (8.6) 14 (40.0) 11 (31.4) 2 (5.7) 0 (0) 1 (2.9) 0 (0) 2 (5.7) 24 (68.6) 5 (14.3) 3 (8.6) 1 (2.9) 8 (7-11) 16±5 5 (5-8) 8.0±2.6 154.1±68.4 223.5±233.2 12 (7-25) 10 (7-18) 7 (6-18) | 0.619 0.427 0.097 0.379 0.055 0.371 0.069 0.858 0.083 0.936 1.000 0.009 0.585 0.297 0.739 0.482 0.592 0.386 1.000 0.022 0.023 0.233 0.312 0.186 0.089 <0.001 0.001 0.300 |
1 |
Vincent J-L, Marshall JC, Ñamendys-Silva SA, François B, Martin-Loeches I, Lipman J, et al. Assessment of the worldwide burden of critical illness: the Intensive Care Over Nations (ICON) audit. Lancet Respir Med. 2014; 2(5):380-6.
doi: 10.1016/S2213-2600(14)70061-X pmid: 24740011 |
2 |
Cohen J, Vincent JL, Adhikari NKJ, Machado FR, Angus DC, Calandra T, et al. Sepsis: a roadmap for future research. Lancet Infect Dis. 2015; 15(5):581-614.
doi: 10.1016/S1473-3099(15)70112-X pmid: 25932591 |
3 |
Rezoagli E, Fumagalli R, Bellani G. Definition and epidemiology of acute respiratory distress syndrome. Ann Transl Med. 2017; 5(14):282.
doi: 10.21037/atm.2017.06.62 pmid: 28828357 |
4 |
Ferguson ND, Kacmarek RM, Chiche JD, Singh JM, Hallett DC, Mehta S, et al. Screening of ARDS patients using standardized ventilator settings: influence on enrollment in a clinical trial. Intensive Care Med. 2004; 30(6):1111-6.
doi: 10.1007/s00134-004-2163-2 pmid: 14991096 |
5 |
Fein AM, Calalang-Colucci MG. Acute lung injury and acute respiratory distress syndrome in sepsis and septic shock. Crit Care Clin. 2000; 16(2):289-317.
doi: 10.1016/s0749-0704(05)70111-1 pmid: 10768083 |
6 |
Iscimen R, Cartin-Ceba R, Yilmaz M, Khan H, Hubmayr RD, Afessa B, et al. Risk factors for the development of acute lung injury in patients with septic shock: an observational cohort study. Crit Care Med. 2008; 36(5):1518-22.
pmid: 18434908 |
7 |
Stapleton RD, Wang BM, Hudson LD, Rubenfeld GD, Caldwell ES, Steinberg KP. Causes and timing of death in patients with ARDS. Chest. 2005; 128(2):525-32.
doi: 10.1378/chest.128.2.525 pmid: 16100134 |
8 |
Thompson BT, Chambers RC, Liu KD. Acute respiratory distress syndrome. N Engl J Med. 2017; 377(6):562-72.
doi: 10.1056/NEJMra1608077 pmid: 28792873 |
9 |
Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, et al. The American-European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994; 149(3 Pt 1):818-24.
doi: 10.1164/ajrccm.149.3.7509706 pmid: 7509706 |
10 |
National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006; 354(24):2564-75.
doi: 10.1056/NEJMoa062200 pmid: 16714767 |
11 |
Mikkelsen ME, Christie JD, Lanken PN, Biester RC, Thompson BT, Bellamy SL, et al. The adult respiratory distress syndrome cognitive outcomes study: long-term neuropsychological function in survivors of acute lung injury. Am J Respir Crit Care Med. 2012; 185(12):1307-15.
doi: 10.1164/rccm.201111-2025OC pmid: 22492988 |
12 |
Flori HR, Church G, Liu KD, Gildengorin G, Matthay MA. Positive fluid balance is associated with higher mortality and prolonged mechanical ventilation in pediatric patients with acute lung injury. Crit Care Res Pract. 2011; 2011:854142.
doi: 10.1155/2011/854142 pmid: 21687578 |
13 |
Rosenberg AL, Dechert RE, Park PK, Bartlett RH, NIH NHLBI ARDS Network. Review of a large clinical series: association of cumulative fluid balance on outcome in acute lung injury: a retrospective review of the ARDSnet tidal volume study cohort. J Intensive Care Med. 2009; 24(1):35-46.
doi: 10.1177/0885066608329850 pmid: 19103612 |
14 |
Cooke CR, Shah CV, Gallop R, Bellamy S, Ancukiewicz M, Eisner MD, et al. A simple clinical predictive index for objective estimates of mortality in acute lung injury. Crit Care Med. 2009; 37(6):1913-20.
doi: 10.1097/CCM.0b013e3181a009b4 pmid: 19384214 |
15 |
Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med. 2013; 369(9):840-51.
doi: 10.1056/NEJMra1208623 pmid: 23984731 |
16 |
Silversides JA, Major E, Ferguson AJ, Mann EE, McAuley DF, Mann JC, et al. Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis. Intensive Care Med. 2017; 43(2):155-70.
doi: 10.1007/s00134-016-4573-3 pmid: 27734109 |
17 |
Sirvent JM, Ferri C, Baro A, Murcia C, Lorencio C. Fluid balance in sepsis and septic shock as a determining factor of mortality. Am J Emerg Med. 2015; 33(2):186-9.
doi: 10.1016/j.ajem.2014.11.016 pmid: 25483379 |
18 |
Alsous F, Khamiees M, DeGirolamo A, Amoateng-Adjepong Y, Manthous CA. Negative fluid balance predicts survival in patients with septic shock: a retrospective pilot study. Chest. 2000; 117(6):1749-54.
doi: 10.1378/chest.117.6.1749 pmid: 10858412 |
19 |
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.
doi: 10.1001/jama.2016.0287 pmid: 26903338 |
20 |
ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, Thompson BT, Ferguson ND, Caldwell E, et al. Acute respiratory distress syndrome: the Berlin Definition. JAMA. 2012; 307(23):2526-33.
doi: 10.1001/jama.2012.5669 pmid: 22797452 |
21 |
Lu Y, Song Z, Zhou X, Huang S, Zhu D, Yang CBX, et al. A 12-month clinical survey of incidence and outcome of acute respiratory distress syndrome in Shanghai intensive care units. Intensive Care Med. 2004; 30(12):2197-203.
doi: 10.1007/s00134-004-2479-y pmid: 15650866 |
22 |
Esteban A, Anzueto A, Frutos F, Alía I, Brochard L, Stewart TE, et al. Characteristics and outcomes in adult patients receiving mechanical ventilation: a 28-day international study. JAMA. 2002; 287(3):345-55.
doi: 10.1001/jama.287.3.345 pmid: 11790214 |
23 |
Kim WY, Hong SB. Sepsis and acute respiratory distress syndrome: recent update. Tuberc Respir Dis (Seoul). 2016; 79(2):53-7.
doi: 10.4046/trd.2016.79.2.53 |
24 |
Murphy CV, Schramm GE, Doherty JA, Reichley RM, Gajic O, Afessa B, et al. The importance of fluid management in acute lung injury secondary to septic shock. Chest. 2009; 136(1):102-9.
doi: 10.1378/chest.08-2706 pmid: 19318675 |
25 |
Amato MB, Barbas CS, Medeiros DM, Magaldi RB, Schettino GP, Lorenzi-Filho G, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998; 338(6):347-54.
doi: 10.1056/NEJM199802053380602 pmid: 9449727 |
26 |
Acute Respiratory Distress Syndrome Network, Brower RG, Matthay MA, Morris A, Schoenfeld D, Thompson BT, et al. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000; 342(18):1301-8.
doi: 10.1056/NEJM200005043421801 pmid: 10793162 |
27 |
Villar J, Kacmarek RM, Perez-Mendez L, Aguirre-Jaime A. A high positive end-expiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute respiratory distress syndrome: a randomized, controlled trial. Crit Care Med. 2006; 34(5):1311-8.
doi: 10.1097/01.CCM.0000215598.84885.01 pmid: 16557151 |
28 |
Hickling KG, Walsh J, Henderson S, Jackson R. Low mortality rate in adult respiratory distress syndrome using low-volume, pressure-limited ventilation with permissive hypercapnia: a prospective study. Crit Care Med. 1994; 22(10):1568-78.
doi: 10.1097/00003246-199422100-00011 pmid: 7924367 |
29 |
Hickling KG, Henderson SJ, Jackson R. Low mortality associated with low volume pressure limited ventilation with permissive hypercapnia in severe adult respiratory distress syndrome. Intensive Care Med. 1990; 16(6):372-7.
doi: 10.1007/BF01735174 pmid: 2246418 |
30 |
Slutsky AS. Mechanical ventilation. Chest. 1993; 104(6):1833-59.
doi: 10.1378/chest.104.6.1833 pmid: 8252973 |
31 |
Stewart TE, Meade MO, Cook DJ, Granton JT, Hodder RV, Lapinsky SE, et al. Evaluation of a ventilation strategy to prevent barotrauma in patients at high risk for acute respiratory distress syndrome. N Engl J Med. 1998; 338(6):355-61.
doi: 10.1056/NEJM199802053380603 pmid: 9449728 |
32 |
Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs. lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA. 2010; 303(9):865-73.
doi: 10.1001/jama.2010.218 pmid: 20197533 |
33 |
Bagshaw SM, George C, Bellomo R. Early acute kidney injury and sepsis: a multicentre evaluation. Crit Care. 2008; 12(2):R47.
doi: 10.1186/cc6863 pmid: 18402655 |
34 |
Prowle JR. Sepsis-associated AKI. Clin J Am Soc Nephrol. 2018; 13(2):339-42.
doi: 10.2215/CJN.07310717 pmid: 29070523 |
[1] | Yu-qing Cui, Xian-fei Ding, Huo-yan Liang, Dong Wang, Xiao-juan Zhang, Li-feng Li, Quan-cheng Kan, Le-xin Wang, Tong-wen Sun. Efficacy and safety of low-dose corticosteroids for acute respiratory distress syndrome: A systematic review and meta-analysis [J]. World Journal of Emergency Medicine, 2021, 12(3): 207-213. |
[2] | Hao-tian Chen, Jian-feng Xu, Xiao-xia Huang, Ni-ya Zhou, Yong-kui Wang, Yue Mao. Blood eosinophils and mortality in patients with acute respiratory distress syndrome: A propensity score matching analysis [J]. World Journal of Emergency Medicine, 2021, 12(2): 131-136. |
[3] | Li-wei Duan, Jin-long Qu, Jian Wan, Yong-hua Xu, Yi Shan, Li-xue Wu, Jin-hao Zheng, Wei-wei Jiang, Qi-tong Chen, Yan Zhu, Jian Zhou, Wen-bo Yu, Lei Pei, Xi Song, Wen-fang Li, Zhao-fen Lin. Effects of viral infection and microbial diversity on patients with sepsis: A retrospective study based on metagenomic next-generation sequencing [J]. World Journal of Emergency Medicine, 2021, 12(1): 29-35. |
[4] | Yi Han, Su-cheng Mu, Jian-li Wang, Wei Wei, Ming Zhu, Shi-lin Du, Min Min, Yun-jie Xu, Zhen-ju Song, Chao-yang Tong. MicroRNA-145 plays a role in mitochondrial dysfunction in alveolar epithelial cells in lipopolysaccharide-induced acute respiratory distress syndrome [J]. World Journal of Emergency Medicine, 2021, 12(1): 54-60. |
[5] | Hai-jiang Zhou, Tian-fei Lan, Shu-bin Guo. Outcome prediction value of National Early Warning Score in septic patients with community-acquired pneumonia in emergency department: A single-center retrospective cohort study [J]. World Journal of Emergency Medicine, 2020, 11(4): 206-215. |
[6] | Miao Yuan, Ding-yi Yan, Fang-shi Xu, Yi-di Zhao, Yang Zhou, Long-fei Pan. Effects of sepsis on hippocampal volume and memory function [J]. World Journal of Emergency Medicine, 2020, 11(4): 223-230. |
[7] | Wen-peng Yin, Jia-bao Li, Xiao-fang Zheng, Le An, Huan Shao, Chun-sheng Li. Effect of neutrophil CD64 for diagnosing sepsis in emergency department [J]. World Journal of Emergency Medicine, 2020, 11(2): 79-86. |
[8] | Shao-hua Liu, Huo-yan Liang, Hong-yi Li, Xian-fei Ding, Tong-wen Sun, Jing Wang. Effect of low high-density lipoprotein levels on mortality of septic patients: A systematic review and meta-analysis of cohort studies [J]. World Journal of Emergency Medicine, 2020, 11(2): 109-116. |
[9] | Yi-wen Fan, Shao-wei Jiang, Jia-meng Chen, Hui-qi Wang, Dan Liu, Shu-ming Pan, Cheng-jin Gao. A pulmonary source of infection in patients with sepsis-associated acute kidney injury leads to a worse outcome and poor recovery of kidney function [J]. World Journal of Emergency Medicine, 2020, 11(1): 18-26. |
[10] | Kimberly A. Chambers, Adam Y. Park, Rosa C. Banuelos, Bryan F. Darger, Bindu H. Akkanti, Annamaria Macaluso, Manoj Thangam, Pratik B. Doshi. Outcomes of severe sepsis and septic shock patients after stratification by initial lactate value [J]. World Journal of Emergency Medicine, 2018, 9(2): 113-117. |
[11] | Hui Xie, Zhi-gang Zhou, Wei Jin, Cheng-bin Yuan, Jiang Du, Jian Lu, Rui-lan Wang. Ventilator management for acute respiratory distress syndrome associated with avian influenza A (H7N9) virus infection: A case series [J]. World Journal of Emergency Medicine, 2018, 9(2): 118-124. |
[12] | Shahin Shadnia, Nasim Zaman, Hossein Hassanian-Moghaddam, Hamed Shafaroodi, Mina Padandar, Mohammad Hasan Rezaeizadeh. Prognostic value of cortisol and thyroid function tests in poisoned patients admitted to toxicology ICU [J]. World Journal of Emergency Medicine, 2018, 9(1): 51-55. |
[13] | Muhammad Akbar Baig, Hira Shahzad, Erfan Hussain, Asad Mian. Validating a point of care lactate meter in adult patients with sepsis presenting to the emergency department of a tertiary care hospital of a low- to middle-income country [J]. World Journal of Emergency Medicine, 2017, 8(3): 184-189. |
[14] | Ruo Wu, Shi-yun Lin, Hui-min Zhao. Albuterol in the treatment of acute respiratory distress syndrome: A meta-analysis of randomized controlled trials [J]. World Journal of Emergency Medicine, 2015, 6(3): 165-171. |
[15] | Xue-zhong Xing, Yong Gao, Hai-jun Wang, Shi-ning Qu, Chu-lin Huang, Hao Zhang, Hao Wang, Qing-ling Xiao, Ke-lin Sun. Effect of sedation on short-term and long-term outcomes of critically ill patients with acute respiratory insufficiency [J]. World Journal of Emergency Medicine, 2015, 6(2): 147-152. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||