Format

Send to

Choose Destination
See comment in PubMed Commons below
Crit Care Med. 2009 Feb;37(2):410-6. doi: 10.1097/CCM.0b013e3181958b1c.

Influence of vasopressor agent in septic shock mortality. Results from the Portuguese Community-Acquired Sepsis Study (SACiUCI study).

Author information

1
Medical Intensive Care Unit, São Francisco Xavier Hospital, Lisbon, Portugal. povoap@netcabo.pt

Abstract

OBJECTIVE:

Guidelines for the adrenergic support of septic shock are controversial. In patients with community-acquired septic shock, we assessed the impact of the choice of vasopressor support on mortality.

DESIGN:

Cohort, multiple center, observational study.

SETTING:

Seventeen Portuguese intensive care units (ICUs).

PATIENTS:

All adult patients admitted to a participating ICU between December 2004 and November 2005.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Patients were followed up during the first five ICU days, the day of discharge or death, and hospital outcome. Eight hundred ninety-seven consecutive patients with community-acquired sepsis (median age, 63 years; 577 men; and hospital mortality, 38%) were studied. Of the 458 patients with septic shock, 73% received norepinephrine and 50.5% dopamine. The norepinephrine group had a higher hospital mortality (52% vs. 38.5%, p = 0.002). A Kaplan-Meier survival curve showed diminished 28-day survival in the norepinephrine group (log-rank = 22.6, p < 0.001). A Cox proportional hazard analysis revealed that the administration of norepinephrine was associated with an increased risk of death (adjusted hazard ratio, 2.501; 95% confidence interval, 1.413-4.425; p = 0.002). In a multivariate analysis with ICU mortality as the dependent factor, Simplified Acute Physiology Score II and norepinephrine administration were independent risk factors for ICU mortality in patients with septic shock.

CONCLUSIONS:

In patients with community-acquired septic shock, our data suggest that norepinephrine administration could be associated with worse outcome.

PMID:
19114885
DOI:
10.1097/CCM.0b013e3181958b1c
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Wolters Kluwer
    Loading ...
    Support Center