Resuscitation with polymeric plasma substitutes is permissive for systemic inflammatory response syndrome and sepsis in multiply injured patients: a retrospective cohort studyReportar como inadecuado




Resuscitation with polymeric plasma substitutes is permissive for systemic inflammatory response syndrome and sepsis in multiply injured patients: a retrospective cohort study - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

European Journal of Medical Research

, 21:39

First Online: 13 October 2016Received: 23 March 2016Accepted: 10 August 2016DOI: 10.1186-s40001-016-0227-8

Cite this article as: Sprengel, K., Simmen, H., Werner, C.M.L. et al. Eur J Med Res 2016 21: 39. doi:10.1186-s40001-016-0227-8

Abstract

ObjectiveMultiple trauma is often accompanied by systemic inflammatory response syndrome SIRS. The aim of this study was to investigate the impact of polymeric plasma substitutes on the development of SIRS or sepsis.

MethodsWe included 2969 patients aged ≥16 years with an Injury Severity Score ISS >16 in this study. The sample was subdivided into three groups: patients who did not receive colloids and those who received <5L colloids and >5L colloids within the first 48 h. Data were analyzed using IBM SPSS for Windows version 22.0; analysis of variance was used for continuous normally distributed data and Kruskal–Wallis test for categorical data. The predictive quality of colloid treatment was analyzed using the receiver operating characteristic ROC curves. Independent predictively was analyzed by binary logistic regression. Data were considered significant if P < 0.05. Data are presented as the mean ± standard deviation.

ResultsThe SIRS score increased with the amount of colloid used 1.9 ± 1.4 vs. 2.4 ± 1.2 vs. 3.2 ± 0.9; P < 0.001. However, the predictive quality was low, with an area under the ROC of 0.693 for SIRS and 0.669 for sepsis P < 0.001. Binary logistic regression revealed colloids as an independent factor for the development of SIRS and sepsis odds ratios: SIRS 3.325 and sepsis 8.984; P < 0.001.

ConclusionBesides other factors, colloids have a significant permissive effect and are independent predictors for the development of SIRS and sepsis in multiply injured patients.

Trial registration ‘Retrospektive Analysen in der Chirurgischen Intensivmedizin’ No. St. V. 01-2008

KeywordsMultiple trauma Systemic inflammatory response syndrome Sepsis Hydroxyethyl starch derivatives AbbreviationsAISAbbreviated Injury Scale

ANOVAanalysis of variance

APACHE IIacute physiology and chronic health evaluation

ATLSadvanced trauma life support

AUCarea under the curve

CARScompensatory anti-inflammatory response syndrome

HEShydroxyl ethyl starch

IBMInternational Business Machines Corporation

IRBInstitutional Review Board

ISSInjury Severity Score

NISSNew Injury Severity Score

ORodds ratio

RESreticulo-endothelial system

ROCreceiver operating curve

SIRSsystemic inflammatory response syndrome

SPSSStatistical Package for the Social Sciences

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Autor: Kai Sprengel - Hanspeter Simmen - Clément M. L. Werner - Simon Sulser - Michael Plecko - Catharina Keller - Ladislav Mic

Fuente: https://link.springer.com/







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