Abstract
Background: Sepsis and infection are among the leading causes of death world-wide. The annual burden of sepsis in high-income countries is rising with a mortality rate of 40% and 90% of the worldwide deaths from pneumonia, meningitis or other infections occur in less developed countries. This study was performed to evaluate the therapeutic efficacy of pentoxifylline as an adjuvant therapy in septic patients and its effect on multiple organ dysfunction and mortality in septic patients. Methods: This randomized, double-blinded prospective study was conducted from October 2017 to November 2018, which included a total sample size of 52 cases of septic patients. Organ dysfunction was used as a primary outcome with proposed large effect size ((0.8) and alfa =0.05 and power=0.80, so, 26 cases were needed in each group). Secondary outcomes were inflammatory markers C-Reactive Protein (CRP) and pro-calcitonin, duration of hospital stay, need for hemodialysis, need for vasopressor & inotropes, need for mechanical ventilation and 28 days survival. Results: Fifty-two patients with sepsis were divided in 1: 1 ratio to receive pentoxifylline or not. The average age of the included patients was almost 53 years, chest disorders were the main cause of sepsis in both groups. There were no statistically significant differences between both groups in terms of Sequential Organ Failure Assessment (SOFA) score, lactate level, CRP level and pro-calcitonin level. As regards secondary outcomes, there were no statistically significant differences between study’s groups in terms of length of hospital stay (p =0.707), need for hemodialysis (p =0.541), need for vasopressor & inotropes (p =0.249), need for mechanical ventilation (p =0.703), and 28 days survival (p =0.5). Conclusion: We concluded that pentoxifylline as an adjuvant therapy in septic patients had no significant influence on multiple organ dysfunction and mortality.
Highlights
Sepsis and infection are among the leading causes of death world-wide
We concluded that pentoxifylline as an adjuvant therapy in septic patients had no significant influence on multiple organ dysfunction and mortality
This study was conducted to evaluate the therapeutic efficacy of pentoxifylline as an adjuvant therapy in severe sepsis and its effect on multiple organ dysfunction and mortality in septic patients. This randomized, double blinded prospective study was conducted between October 2017 to November 2018 at Ain Shams University Hospitals' Intensive Care Units and Maadi Military Hospital on patients with severe sepsis according to the definitions of Sepsis Surviving Campaign (SSC) 2016 [3]
Summary
The annual burden of sepsis in high income countries is rising with a mortality of 40%. Despite these figures from industrialized countries, the largest part of the global sepsis burden occurs in middle and low- income countries, 90% of the worldwide deaths from pneumonia, meningitis or other infections occur in less developed countries [1]. In 2016, the surviving sepsis campaign defined sepsis as a life-threatening organ dysfunction caused by the dysregulated host response to an infection [3]. The annual burden of sepsis in high-income countries is rising with a mortality rate of 40% and 90% of the worldwide deaths from pneumonia, meningitis or other infections occur in less developed countries. This study was performed to evaluate the therapeutic efficacy of pentoxifylline as an adjuvant therapy in septic patients and its effect on multiple organ dysfunction and mortality in septic patients
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