| Abstract | Cilj istraživanja: Primarni cilj ovog istraživanja bio je utvrditi dinamiku kretanja tjelesne temperature tijekom prva 72 sata u bolesnika u septičkom šoku i ustanoviti postoje li razlike između preživjelih i preminulih bolesnika. Sekundarni ciljevi bili su analizirati laboratorijske nalaze, nalaze hemokultura, primjenu antipiretske terapije i osnovno zdravstveno stanje (komorbiditete) među navedenim skupinama te utvrditi njihov utjecaj na piretski odgovor domaćina.
Materijali i metode: U istraživanje je uključeno 139 bolesnika kojima je u razdoblju od 1. siječnja 2013. do 31. prosinca 2020. godine pri prijemu ili tijekom boravka u Jedinici intenzivnog liječenja Firule Klinike za anesteziologiju, reanimatologiju i intenzivno liječenje KBC-a Split postavljena dijagnoza septičkog šoka. Ispitanici su podijeljeni u dvije skupine prema konačnom ishodu liječenja (preživjeli ili smrtni ishod) te su one uspoređene s obzirom na demografske podatke, temperaturne vrijednosti unutar 72 sata od razvoja šoka, laboratorijske nalaze, nalaze hemokultura, liječenje antipireticima i određene komorbiditete bolesnika.
Rezultati: Od ukupno 139 bolesnika s postavljenom dijagnozom septičkog šoka, preživjelo je njih 39 dok ih je 100 preminulo. U ukupno 80 bolesnika (34 preživjelih i 46 preminulih) u kojih je septički šok trajao bar 72 sata, srednje vrijednosti svih mjerenja bile su više u preminulih (37,0 ± 0,8°C) u odnosu na preživjele bolesnike (36,8 ± 0,7°C) uz statističku značajnost P<0,001. Prosječna razlika maksimalne i minimalne temperature bila je značajno veća u preminulih bolesnika (2,1 ± 0,9 u preživjelih vs. 2,4 ± 1,0°C u preminulih bolesnika, P=0,037). Među skupinama preživjelih i preminulih bolesnika pronađene su statistički značajne razlike u maksimalnim vrijednostima laktata (3,9 ± 3,7 u preživjelih vs. 8,0 ± 5,4 mmol/L u preminulih bolesnika, P<0,001) te minimalnim pH vrijednostima (7,24 ± 0,12 u preživjelih vs. 7,12 ± 0,17 u preminulih bolesnika, P<0,001). U bolesnika bez komorbiditeta, za razliku od onih s komorbiditetima, nađena je statistički značajno veća vrijednost maksimalno izmjerene temperature u preminulih bolesnika (37,7 ± 0,9 u preživjelih vs. 38,4 ± 1,5°C u preminulih bolesnika, P=0,035).
Zaključak: Postoji značajna razlika u dinamici kretanja tjelesne temperature tijekom prva 72 sata između preživjelih i preminulih bolesnika u septičkom šoku. Maksimalna serumska razina laktata kao i minimalna pH vrijednost statistički značajno pozitivno koreliraju s rizikom od smrtnog ishoda u ovih bolesnika. |
| Abstract (english) | Objectives: The primary aim of this research was to determine the dynamic of body temperature values during the first 72 hours in septic shock patients and to determine whether there is a difference between patients who have survived and those who have deceased. The secondary aim was to analyze lab results, blood culture findings, use of antipyretic therapy and patient comorbidities between said groups, as well as to determine their impact on the pyretic response of the host.
Materials and methods: A total of 139 patients who were diagnosed with septic shock during admission or their stay in the Intensive Care Unit Firule of the Department of Anesthesiology, Reanimation and Intensive Care at the University Hospital of Split over the period from January 1st, 2013 to December 31st, 2020, were included in this study. Patients were divided into two groups based on their final outcome (survival or death) and the groups were compared with regard to their demographic data, body temperature value within the first 72 hours of shock, lab results, blood culture findings, use of antipyretic therapy and patient comorbidities.
Results: Out of 139 included patients who were diagnosed with septic shock, 100 patients have died, while 39 of them survived. Out of 80 patients (34 alive and 46 deceased) whose septic shock lasted for at least 72 hours, mean values of all measurements were higher in the deceased (37,0 ± 0,8°C) compared to patients who have survived (36,8 ± 0,7°C) with a statistically significant difference P<0.001. The mean difference between maximum and minimum temperature was significantly greater in deceased patients (2,1 ± 0,9 in survivors compared to 2,4 ± 1,0°C in deceased patients, P=0.037). In both groups, there was a statistically significant difference in maximum lactate value (3,9 ± 3,7 in survivors compared to 8,0 ± 5,4 mmol/L in deceased patients, P<0.001) and minimal pH value (7,24 ± 0,12 in survivors compared to 7,12 ± 0,17 in deceased patients, P<0.001). In the patients with no comorbidities, unlike those with comorbidities, there was a statistically significant difference in maximum body temperature value in deceased patients (37,7 ± 0,9 in survivors compared to 38,4 ± 1,5°C in deceased patients, P=0.035).
Conclusion: There was a significant difference in the dynamic of body temperature values during the first 72 hours of septic shock between patients who have survived and those who have died. Maximum serum lactate value and minimal pH value correlate positively with a higher risk of death in these patients. |
