Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.ajem.2018.02.020
Title: Evaluation for occult sepsis incorporating NIRS and emergency sonography
Authors: Ng, Natalie Yu Yi
Ang, Hannah Hui En
Tan, Jacqueline Chieh Ling
Ho, Weng Hoe 
Kuan, Win Sen 
Chua, Mui Teng 
Keywords: Science & Technology
Life Sciences & Biomedicine
Emergency Medicine
Sepsis
Ultrasonography
Point-of-care tests
Tissue oxygen saturation
NEAR-INFRARED SPECTROSCOPY
MICROVASCULAR BLOOD-FLOW
TISSUE OXYGEN-SATURATION
CRITICALLY-ILL PATIENTS
SEPTIC SHOCK
DEPARTMENT PATIENTS
ORGAN DYSFUNCTION
PROGNOSTIC VALUE
MUSCLE
RESUSCITATION
Issue Date: 1-Nov-2018
Publisher: W B SAUNDERS CO-ELSEVIER INC
Citation: Ng, Natalie Yu Yi, Ang, Hannah Hui En, Tan, Jacqueline Chieh Ling, Ho, Weng Hoe, Kuan, Win Sen, Chua, Mui Teng (2018-11-01). Evaluation for occult sepsis incorporating NIRS and emergency sonography. AMERICAN JOURNAL OF EMERGENCY MEDICINE 36 (11) : 1957-1963. ScholarBank@NUS Repository. https://doi.org/10.1016/j.ajem.2018.02.020
Abstract: © 2018 Elsevier Inc. Purpose: We aim to determine whether the combination of regional tissue oxygen saturation (StO2) measurement using near-infrared spectroscopy (NIRS), inferior vena cava (IVC) collapsibility and ejection fraction (EF) is able to detect occult sepsis. Methods: We included adult patients in the emergency department with at least one of the following: fever; any one component of the quick sepsis-related organ function assessment (SOFA) score; heart rate ≥ 100 beats per minute; or white cell count <4.0 × 109/L or >12.0 × 109/L. StO2parameters, IVC collapsibility and EF were assessed. Primary outcome was composite of admission to intensive care unit, hypotension requiring fluid resuscitation or vasopressor use, and antibiotic escalation. Results: We included 184 patients with mean age of 55.4 years and slight male predominance (51.6%). Increase in temperature (adjusted odds ratio [aOR] 3.05; 95% confidence interval [CI] 1.16 to 8.02), higher white cell counts (aOR 1.10; 95% CI 1.03 to 1.19), increase in time taken to new StO2baseline (aOR 1.03; 95% CI 1.01 to 1.06) and reduced EF (aOR 33.9; 95% CI 2.19 to 523.64) had higher odds of achieving the primary outcome. Conclusion: Change in StO2and time taken to reach new StO2baseline, combined with EF could potentially predict sepsis among patients with infection.
Source Title: AMERICAN JOURNAL OF EMERGENCY MEDICINE
URI: https://scholarbank.nus.edu.sg/handle/10635/156729
ISSN: 0735-6757
1532-8171
DOI: 10.1016/j.ajem.2018.02.020
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