Greetings All
Is the Rivers paper from 2001 something that we still
stick by? I just had a look at the methods section and it
seems the only thing different from "standard care (which
involved CVP, MAP and UO monitoring) was measurement of
central venous O2 sats.
Is SVO2 still something that's routinely looked after? I
had a feeling this paper had been "superceded" in some
way.
Thanks very much indeed
Tom Morris
(ID/Micro Registrar, John Radcliffe Hospital, Oxford)
On Mon, 27 Feb 2012 09:48:16 -0800
Andy Bourgeois <[email protected]> wrote:
SIRS criteria have been defined differently in various
studies.
The temperature was 38 degrees C in a few early
articles:
*One of the early definitions of sepsis:*
Definitions for sepsis and organ failure and guidelines
for the use of
innovative therapies in sepsis. The ACCP/SCCM Consensus
Conference
Committee. American College of Chest Physicians/Society
of Critical Care
Medicine.
Bone RC, Balk RA, Cerra FB, Dellinger RP, Fein AM, Knaus
WA, Schein RM,
Sibbald WJ.
Chest. 1992 Jun;101(6):1644-55. Review
*The original Early Goal Directed Therapy article from
2001*
Early goal-directed therapy in the treatment of severe
sepsis and septic
shock.
Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A,
Knoblich B, Peterson E,
Tomlanovich M; Early Goal-Directed Therapy Collaborative
Group.
N Engl J Med. 2001 Nov 8;345(19):1368-77.
Most of the more recent studies and reviews use 38.3
degrees C:
*International Sepsis Definitions Conference in 2001*
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis
Definitions Conference.
Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook
D, Cohen J, Opal
SM, Vincent JL, Ramsay G; SCCM/ESICM/ACCP/ATS/SIS.
Crit Care Med. 2003 Apr;31(4):1250-6. Review.
*In this 2006 review article from some of the original
Early Goal Directed
Therapy investigators:*
Severe sepsis and septic shock: review of the literature
and emergency
department management guidelines.
Nguyen HB, Rivers EP, Abrahamian FM, et al.
Ann Emerg Med. 2006 Jul;48(1):28-54. Epub 2006 May 2.
Review.
*The Surviving Sepsis Campaign - 2008*
Surviving Sepsis Campaign: international guidelines for
management of
severe sepsis and septic shock: 2008.
Dellinger RP, Levy MM, Carlet JM, et al.
Crit Care Med. 2008 Jan;36(1):296-327. Erratum in: Crit
Care Med. 2008
Apr;36(4):1394-6.
I'd recommend 38.3 degrees C to match the more recent
definitions so that
your sepsis statistics can be easily compared to
published studies.
Here's an article on comparison of methods of measuring
temperature.
Bottom line is that IR ear probes are somewhat variable
and axillary reads
too low. Go with oral, rectal or bladder.
Erickson RS, Kirklin SK. Comparison of ear-based,
bladder, oral, and
axillary
methods for core temperature measurement. Crit Care Med.
1993
Oct;21(10):1528-34.
PubMed PMID: 8403963.
Andy Bourgeois, MD, FAAEM, FACEP
Emergency Medicine
Simi Valley Hospital
On Thu, Feb 23, 2012 at 11:47 AM, Johnston, Roberta <
[email protected]> wrote:
Hi everyone- Our Sepsis committee would like to know if
the temp
criteria is 38.3 or 38, and is the method of obtaining
the temperature?
Thanks in advance, Roberta****
** **
Roberta Johnston, RN,BS,CMC.
Cardiopulmonary Case Manager
700 High St.
Williamsport, Pa. 17701
Phone:570-321-2112, Fax:570-321-2822;Cell: 570-560-8993
[email protected]****
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