| Autor: |
L G, Costongs, P, Speelman, J J, van Lieshout, S J, van Deventer, M J, Lubbers, H G, Schipper |
| Jazyk: |
Dutch; Flemish |
| Rok vydání: |
1993 |
| Předmět: |
|
| Zdroj: |
Nederlands tijdschrift voor geneeskunde. 137(7) |
| ISSN: |
0028-2162 |
| Popis: |
Evaluation of HA-1A treatment in patients with the sepsis syndrome.Descriptive.Department of intensive care, Academic Medical Centre, Amsterdam.Intensive-care patients with the sepsis syndrome and shock or organ failure with a presumptive diagnosis of Gram-negative infection were eligible for treatment with HA-1A. We analysed and compared the results with those of the double-blind, randomized HA-1A study by Ziegler et al.Between May 1991 and March 1992, 27 patients were treated with HA-1A. The mortality rate was 59% (16/27). Among the 11 patients with a Gram-negative bacteraemia mortality was 7/11, much higher than in the Ziegler study (30%). In comparison with the HA-1A study we selected sicker patients: the mean APACHE II score was higher, 93% of our patients were in shock and 85% had organ failure. More patients presented with an intra-abdominal sepsis and mortality in this group was very high (11/14). In patients with a Gram-negative bacteraemia the delay between the onset of the sepsis syndrome and the administration of HA-1A was longer (median 22 h versus 14.3 h in the Ziegler study, mean 30 versus 20 h).HA-1A does not appear to be beneficial in critically ill patients with a longstanding sepsis syndrome, especially not if an intra-abdominal sepsis is apparent. Therefore, we decided not to use H-1A until additional data become available. Additional objective inclusion criteria are needed to improve the identification of the patient group that may benefit from treatment with HA-1A. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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