[The effects of earlier resuscitation on following therapeutic response in sepsis with hypoperfusion].
OBJECTIVE
To evaluate the effects of early sufficient resuscitation on important organs function and their therapeutic response in sepsis with hypoperfusion.


METHODS
From January 2004 to December 2005, 34 sepsis patients with hypoperfusion in surgical and respiratory intensive care units were resuscitated sufficiently for the management of severe sepsis and septic shock. According to the time of resuscitation end points, these patients were divided to early resuscitation group (E group, 15 patients) and later group (L group, 19 patients). The important organs function and their therapeutic response followed resuscitation were investigated and compared in the tow groups.


RESULTS
After earlier sufficient resuscitation, the incidence of repeated resuscitation was 73.7% in L group and 20.0% in E group (P < 0.01); the incidence of steroids replacement, coagulation dysfunction and multiple organ dysfunction syndrome (MODS) were 63.2%, 73.7% and 68.4% respectively in L group and significantly higher than those in E group (P < 0.05). Seven days after resuscitation, the level of serum creatinine in E group was lower than that in L group (P < 0.05). In the day 1 and 7 after resuscitation, heart rate in E group was lower than that in L group (P < 0.05). Seven days post resuscitation, PaO(2) and PaO(2)/FiO(2) were higher in E group than in L group (P < 0.05). The mortality was 42.1% in L group and 13.3% in E group (P < 0.05).


CONCLUSIONS
Early sufficient resuscitation in sepsis patients with hypoperfusion could significantly enhance the effects of following treatment, relieve inflammation and coagulation reaction and thereby reduce the mortality.
Qu
Hong-ping
HP
Department of Respiratory Intensive Care Unit, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China. hongpingqu@yahoo.com.cn
Qin
Shuai
S
Min
Dong
D
Tang
Yao-qing
YQ
D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000379:methods*; D018805:Sepsis / Q000150:complications / Q000628:therapy*; D012772:Shock, Septic / Q000209:etiology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome