低温败血症患者的温度轨迹和死亡率
Dongkwan Han1, Seung Hyun Kang1, Young Woo Um1
1Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.
The American journal of emergency medicine
|July 24, 2024
概括
低温性败血症患者的体温在6小时内升高1°C或以上,显示28天死亡率降低. 这种温度轨迹对于预测败血症患者的结果至关重要.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 生理学 生理学 生理学
背景情况:
- 低温是已知预测性毒症不良结果的一个预测因素.
- 败血症患者在治疗期间经常经历显著的体温波动.
- 了解这些温度变化对于预后至关重要.
研究的目的:
- 根据体温变化对低温性败血症患者进行分类.
- 为了确定温度轨迹和28天死亡率之间的关联.
主要方法:
- 从成年败血症患者的前性收集数据的回顾性分析.
- 低温性败血症被定义为最初的体温<36°C.
- 根据6小时温度变化分组的患者: ≤0°C (A组), 0-1°C (B组), >1°C (C组).
主要成果:
- 低温性败血症的整体死亡率为36%.
- 幸存者比没有幸存者更高6小时的温度.
- 28天死亡率:A组 (53.1%),B组 (36.0%),C组 (30.0%). 这三种类型的死亡率分别为:
- 而C组的死亡率明显低于A组 (aHR为0.558).
结论:
- 在6小时内体温上升≥1°C与低温性败血症的更好的生存率有关.
- 初始治疗后体温正常化或升高与28天死亡率降低有关.
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