Palabras clave
Choque séptico
Antibacterianos
Pronóstico Sepsis
Septic shock
Anti-bacterial agents
Prognosis
Cómo citar
Resumen
Antecedentes: La sepsis constituye una importante causa de mortalidad en cuidado intensivo generando elevado consumo de recursos. Los estudios nacionales son limitados. Objetivo: Se pretende describir el curso clínico de pacientes Sépticos, durante 6 meses en una unidad de cuidado intensivo polivalente. Metodología: Estudio descriptivo observacional. Se midieron variables clínicas, epidemiológicas, estancia, soportes, estado vital, severidad. Con el consenso SEPSIS-3 del 2016 se realizó análisis de subgrupo de 58 pacientes siendo el primer estudio local en pacientes sépticos con base al nuevo consenso internacional. Resultados: Se incluyeron 129 pacientes: 101 (78%) cursaron con choque séptico. La sobrevida fue de 79,8% (n103) con mortalidad de 20,1% (n26). 28% requirieron inotropía, 12% terapia renal. Origen del cuadro séptico: pulmonar (36%), abdominal (34%) y urinario (13,1%); 36.7% cursaron con disfunción multiorgánica. En 82% hubo toma de cultivo, 57% fueron positivos, 49.6% Infección adquirida en la comunidad y 50.3% asociada al cuidado hospitalario; sin diferencias en la supervivencia (p=0.087). Tener Glasgow>13, menor sedación, APACHE<15, no requerir vasopresores ni ventilación mecánica, no presentar disfunción multiorgánica y menor lactato se asociaron a mayor sobrevida. Conclusiones: Comparado con otros estudios se evidenció menor mortalidad. El ingreso temprano a cuidado intensivo, intensivista 24 horas, reanimación temprana desde urgencias, equipos de respuesta rápida y determinantes epidemiológicos, constituyen factores modificables de resultado de enfermedad. Se requiere diseño y desarrollo de estudios locales con la definición del tercer consenso y con la aplicación prospectiva del qSOFA, facilitando el reconocimiento temprano en sepsis.
Citas
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