Perfil clínico de pacientes que foram a óbito por choque séptico na unidade de terapia intensiva

Abstract

Sepsis is theleading cause of death in the intensive care unit (ICU) and is a mongthe leading causes of death world wide. This study aimed to analyze the clinical profile of patients Who died dueto septic shock in the ICU of a public hospital in Salvador, Bahia, Brazil. This is a descriptive, exploratory, and retrospective study. The data were gathered from the medical records, in the period from July to September 2013. Were selected for analysis 170 medical records. Among the sellectioned, 47 were not found, and 7 could not be studied because of the difficulty in understanding the records found in the ICU, the end 35 records were used. The median age was 60 years, there was a predominance off emales, not white, retired, and living in Salvador, Bahia, Brazil admitted by the emergency room, and admitted to the ICU coming from the wardsand operating room/post-anesthesia care unit, some of the malready with septic shock. The main comorbidity found was chronic renal failure, and in relation torisk factor sthehigh lighted were hypertension, diabetes mellitus andalcoholism. 51,4% of the patients studied officially progressed to septics hock during the ICU stay, with positive blood culture sand having Acinetobacterbaumanniias the main microorganism. All of the mused prophylactic antibiotic sand vasopressors, being them ain vasopressor drug Noradrenaline. 40% of the patients did not use prior or volume associated expansion with vasopressor, made some kind of dialysis, and used considerable number of invasive catheters. All patients had serum lactate analyzed, and septic shock was the main cause of death for all patients. Thus, it was possible to show a high incidence of septic shock in the study unit.Thus, it was possible to evidence a high incidence of septic shock in the unit and the period studied. It was evidenced that patients Who died of septic shock did not use the proper treatment for the diagnosis of sepsis, and was also not possible to evaluate whet herth etreatment off ered was performe dimme diately after diagnosis dueto lack of medical Record saboutthe beginnin goft hedisease. In this context, it is necessary the develop mentan dimplementation of clinical protocols for the proper management and prevention of sepsis, severe sepsis, and septic shock, as well as training health Professionals to the early recognition of the sepsis stages; there fore, reaching a careful optimization according to the most current levels of evidence and grades of recommendation.