Background
Methods
Entry criteria | Septic shock ALBIOS | Shock-2 present study | Shock-3 present study | |
---|---|---|---|---|
Severe sepsis + cardiovascular Sepsis-related Organ Failure Assessment score 3 or 4 | As septic shock ALBIOS, in which baseline lactate was available | Shock-2 patients with baseline lactate > 2 mmol/L | ||
Patients |
n
| 1135 | 1098 | 721 |
Patients lost at follow up |
n
| 14 | 12 | 8 |
Mortality data available |
n
| 1121 | 1086 | 713 |
Statistical analysis
Results
Patients with septic shock
Shock 2 N = 1098 | Shock 3 N = 721 | |||||
---|---|---|---|---|---|---|
Albumin N = 549 | Crystalloids N = 549 | p value | Albumin N = 346 | Crystalloids N = 375 | p value | |
MAP (mmHg) | 70.9 ± 14.4 | 70.8 ± 14.1 | 0.958a | 70.4 ± 14.8 | 69.0 ± 14.0 | 0.190a |
CVP (mmHg) | 10.8 ± 5.0 | 10.8 ± 4.9 | 0.877a | 11.0 ± 5.1 | 10.8 ± 4.9 | 0.583a |
HR (bpm) | 106.5 ± 22.1 | 106.8 ± 20.4 | 0.819a | 109.8 ± 21.5 | 109.2 ± 19.8 | 0.672a |
SvO2 (%) | 71.4 ± 11.14 | 73.3 ± 10.0 | 0.005a | 70.7 ± 11.9 | 73.0 ± 10.2 | 0.007a |
PaCO2 (mmHg) | 39.2 ± 12.4 | 39.2 ± 9.7 | 0.960a | 38.1 ± 11.4 | 38.67 ± 9.8 | 0.455 |
PvCO2 (mmHg) | 46.7 ± 12.6 | 46.3 ± 10.3 | 0.524a | 45.9 ± 11.8 | 45.69 ± 10.7 | 0.833a |
Noradrenaline (μg/kg/min) | 1.9 ± 0.8 | 1.3 ± 0.6 | 0.042a | 1.9 ± 0.9 | 1.3 ± 0.6 | 0.126a |
Patients on noradrenaline | 463 (84.3%) | 458 (83.4%) | 0.682c | 296 (85.5%) | 321 (85.6%) | 0.985c |
Lactate (mmol/L) | 3.7 ± 3.2 | 4.1 ± 3.4 | 0.040b | 5.11 ± 3.3 | 5.31 ± 3.4 | 0.487b |
pH | 7.40 ± 0.1 | 7.4 ± 0.1 | 0.883a | 7.35 ± 0.1 | 7.34 ± 0.1 | 0.597a |
BE (mmol/L) | −3.9 ± 6.1 | −3.7 ± 6.2 | 0.800b | −4.8 ± 6.2 | −4.6 ± 6.2 | 0.937b |
Albumin (g/L) | 23.5 ± 6.3 | 24.1 ± 6.1 | 0.138b | 23.4 ± 6.4 | 23.9 ± 6.2 | 0.617b |
Creatinine (mg/dL) | 2.2 ± 1.7 | 2.1 ± 1.5 | 0.153a | 2.3 ± 1.6 | 2.2 ± 1.5 | 0.175a |
Diuresis (ml/h) | 70.6 ± 71.1 | 72.7 ± 76.5 | 0.610b | 68.8 ± 73.3 | 69.2 ± 75.7 | 0.847b |
Fluid balance (6 h) (L) | 1.2 ± 1.4 | 1.2 ± 1.7 | 0.549b | 1.4 ± 1.5 | 1.5 ± 1.8 | 0.918b |
Fluid input (day 1) (L) | 4.8 ± 2.3 | 4.8 ± 2.3 | 0.917b | 5.1 ± 2.4 | 5.1 ± 2.5 | 0.710b |
SOFA | 9.3 ± 2.6 | 9.4 ± 2.8 | 0.782b | 9.9 ± 2.7 | 9.9 ± 2.8 | 0.906b |
SAPS II | 52.1 ± 17.0 | 52.7 ± 17.1 | 0.592a | 55.6 ± 17.0 | 55.8 ± 17.1 | 0.911a |
Mortality (90 day) | 237 (43.6%) | 270 (49.8%) | 0.039c | 167 (48.7%) | 203 (54.9%) | 0.099c |
WBC | 13.4 ± 10.3 | 13.2 ± 10.8 | 0.762a | 12.9 ± 11.0 | 12.6 ± 11.5 | 0.644a |
PLT | 176 ± 118 | 181 ± 131 | 0.873b | 156 ± 109.9 | 164 ± 126.1 | 0.592b |
Patients without shock
Sepsis and albumin
Patients defined by Shock-2
Discussion
Study | TRISS [5] | SEPSISPAM [6] | ProCESS [7] | ARISE [8] | ALBIOS [1] | VASST [12] |
---|---|---|---|---|---|---|
Patients enrolled (n) | 1005 | 776 | 1341 | 1600 | 1135 | 778 |
Enrollment mid-date | 2012 | 2011 | 2011 | 2011 | 2010 | 2003 |
Enrollment period (months) | 25 | 22 | 74 | 66 | 42 | 57 |
Centers (n) | 32 | 29 | 31 | 51 | 100 | 27 |
Enrollment rate (patients/month/center) | 1.26 | 1.22 | 0.58 | 0.24 | 0.27 | 0.52 |
Enrollment rate (patients/month) | 40.3 | 35.4 | 18 | 12 | 27 | 14 |