Evaluation for occult sepsis incorporating NIRS and emergency sonography

Purpose - We aim to determine whether the combination of regional tissue oxygen saturation (StO2) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. - Methods - We included adult patients in the eme...

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Hauptverfasser: Ng, Natalie Yu Yi (VerfasserIn) , Ang, Hannah Hui En (VerfasserIn) , Tan, Jacqueline Chieh Ling (VerfasserIn) , Ho, Weng Hoe (VerfasserIn) , Kuan, Win Sen (VerfasserIn) , Chua, Mui Teng (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 27 February 2018
In: The American journal of emergency medicine
Year: 2018, Jahrgang: 36, Heft: 11, Pages: 1957-1963
ISSN:1532-8171
DOI:10.1016/j.ajem.2018.02.020
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.ajem.2018.02.020
Verlag, lizenzpflichtig, Volltext: http://www.sciencedirect.com/science/article/pii/S0735675718301542
Volltext
Verfasserangaben:Natalie Yu Yi Ng, Hannah Hui En Ang, Jacqueline Chieh Ling Tan, Weng Hoe Ho, Win Sen Kuan, Mui Teng Chua

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520 |a Purpose - We aim to determine whether the combination of regional tissue oxygen saturation (StO2) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. - Methods - We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate≥100 beats per minute; or white cell count <4.0×109/L or >12.0×109/L. StO2 parameters, IVC collapsibility and EF were assessed. Primary outcome was composite of admission to intensive care unit, hypotension requiring fluid resuscitation or vasopressor use, and antibiotic escalation. - Results - We included 184 patients with mean age of 55.4years and slight male predominance (51.6%). Increase in temperature (adjusted odds ratio [aOR] 3.05; 95% confidence interval [CI] 1.16 to 8.02), higher white cell counts (aOR 1.10; 95% CI 1.03 to 1.19), increase in time taken to new StO2 baseline (aOR 1.03; 95% CI 1.01 to 1.06) and reduced EF (aOR 33.9; 95% CI 2.19 to 523.64) had higher odds of achieving the primary outcome. - Conclusion - Change in StO2 and time taken to reach new StO2 baseline, combined with EF could potentially predict sepsis among patients with infection. 
650 4 |a Point-of-care tests 
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650 4 |a Tissue oxygen saturation 
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