Outcome of severe sepsis in the ICU is independent of haemoglobin levels

J Wood,D Pandit

doi:10.1186/cc7513

Abstract

In this observational cohort study we attempted to elucidate a haemoglobin (Hb) target that favours the mortality outcome in severe sepsis patients. The optimum level of Hb to influence outcome in severe sepsis is yet to be determined. Although the analysis of severe sepsis patients in the Canadian transfusion requirement in critical care study [1] did not find any mortality benefit with a Hb level of 10 g/dl or above, the early goal-directed therapy trial [2] showed significant mortality benefit by achieving haematocrit ≥ 30%, equivalent to a Hb value of 10 g/dl, during the early treatment period. This pilot study was therefore undertaken to look for any relationship between Hb levels and mortality in severe sepsis patients admitted to the ICU.

Highlights

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients
SvO2 was lower than ScvO2 (70.2 ± 11.4% vs. 78.6 ± 10.2%; P
Results of this study show that early tracheostomy, if perioperative complications

Summary

Introduction

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients. Conclusions Our data demonstrate that critically ill patients may be exposed to a higher FiO2 than that required to maintain adequate oxygenation These results highlight an area of ICU care that has received little study, with no published clinical trials examining the effect of FiO2 on outcome. Results Age, sex, the underlying disease and tumour stage (TNM classification), type of previous anticancer treatment, performance status, severity scores (APACHE II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment), ICU and hospital mortalities and hospital outcome at 3, 6 and 12 months were analysed. Clinical data of 277 post-transplantation patients admitted to the ICU were collected at admission and the SAPS 3 and APACHE II score calculated with respective estimated mortality rates.

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