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FACP. Colegio de médicos de Tarragona Nº 4305520 / fgcapriles@gmail.com




Monday, November 28, 2016

Non Confirmed Septic Shock

Contou D et al. Critical Care 2016; 20:360
DOI: 10.1186/s13054-016-1537-5 - Published: 6 November 2016
..."The main results of our pragmatic study are as follows: (1) a quarter of patients admitted to ICUs with suspected septic shock had no infection identified at 24 h after onset of shock and almost half of them had a septic shock mimicker; (2) septic shock mimickers were mostly due to acute mesenteric ischemia or adverse effects of drugs; and (3) outcomes did not differ between EC-SS and non EC-SS patients.
Our study showed that using conventional microbiological methods, one quarter of the patients admitted to the ICU with clinical presentation of septic shock had no infection identified 24 h after introduction of vasopressors, and almost half of these patients had a non-infectious diagnosis that mimicked sepsis. We identified several causes of septic shock mimickers for which patients with suspected septic shock of no apparent etiology should be screened. Outcomes did not differ between patients with early-confirmed septic shock and other patients. Seven percent of the patients admitted on suspicion of septic shock had no cause identified by the end of ICU stay. Further studies are needed to assess the diagnostic yield of molecular detection methods in this subgroup of patients."