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Comparison of Survival Prediction with Single versus Combination Use of Microcirculation End Point Resuscitation in Sepsis and Septic Shock

ACTA MEDICA INDONESIANA · Vol. 50 No. 4 (2019)

ISSN
2338-2732, 0125-9326
Published
2019-01-11
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: lactate clearance and central venous oxygen saturation (ScvO2) are two methods for determining tissue oxygenation adequacy. There is a controversy regarding method better associates with and predicts sepsis and septic shock patients’ mortality. This study address the association of achieving one or two targets of microcirculatory resuscitation endpoints and early mortality in sepsis and septic shock. Methods: a cohort study was conducted in adult sepsis and septic shock patients in Intensive Care Unit, Cipto Mangunkusumo Hospital, Indonesia. Patients’ resuscitation endpoints data and outcome were observed during the first 120 hours of hospitalization. Cox’s proportional hazard regression analysis was used to analyse the early mortality risk in subject groups achieving lactate clearance target only, ScvO2 target only, both targets, and not achieving any target in 6 hours after onset of resuscitation adjusted for number of organ dysfunction. Results: subjects consisted of 268 patients. There were significant differences in the mortality risk between subjects who achieved both targets with subjects who achieved ScvO2 target only (adjusted hazard ratio [aHR] 13.47; 95% confidence interval [CI] 5.17-35.08) and subjects who not achieve any target (aHR 16.12; 95%CI 7.43-34.95). There were insignificant difference the early mortality risk between subjects who achieved both targets with subjects achieved lactate clearance target only (aHR 2.29; 95%CI 0.83-6.32). Conclusion: in patients with sepsis and septic shock, achievement of lactate clearance and ScvO2 targets associates with similar early mortality risk compared to achievement of lactate clearance target only. However, it associates with lower early mortality risk compared with ScvO2 target only.

Keywords

Collaboration network of the authors

40 authors · 167 co-authorship links · showing the 40 most connected

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  • University of Indonesia
  • Affiliation unknown
  • Different organisations
  • Same organisation
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Co-authorOrganisationJoint articles
Khie Chen LieAffiliation unknown9
Leonard NainggolanAffiliation unknown7
Sharifah ShakinahAffiliation unknown7
Erni Juwita NelwanAffiliation unknown6
Kuntjoro HarimurtiAffiliation unknown4
Adeline PasaribuAffiliation unknown4
Ikhwan RinaldiAffiliation unknown4
Randy AdiwinataAffiliation unknown3
Cleopas Martin RumendeAffiliation unknown3
Erni J NelwanAffiliation unknown3
Hamzah ShatriAffiliation unknown3
Idrus AlwiAffiliation unknown2
Rudi PutrantoAffiliation unknown2
Suryo Anggoro Kusumo WibowoAffiliation unknown2
Noto DwimartutieAffiliation unknown2
Irsan HasanAffiliation unknown2
Adeline Intan PasaribuAffiliation unknown2
Siti SetiatiAffiliation unknown2
Arif MansjoerAffiliation unknown2
Bambang SutrisnaUniversity of Indonesia1
Sarwono WaspadjiAffiliation unknown1
Herdiman T PohanAffiliation unknown1
Evi IndrasantiAffiliation unknown1
Farida NurchaidaAffiliation unknown1
Rustadi SosrosumihardjoAffiliation unknown1
Andi KristantoAffiliation unknown1
Silvia SumintoAffiliation unknown1
Benny N KurniawanAffiliation unknown1
Finna ChristiantyAffiliation unknown1
Rino A GaniAffiliation unknown1
Laurentius A LesmanaAffiliation unknown1
Jacub PandelakiAffiliation unknown1
Siti B KresnoAffiliation unknown1
Tonny LohoAffiliation unknown1
Rahajeng N TunjungputriAffiliation unknown1
Narottama TunjungAffiliation unknown1
Helio GuterresAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">Comparison of Survival Prediction with Single versus Combination Use of Microcirculation End Point Resuscitation in Sepsis and Septic Shock</dc:title>
	<dc:creator>Sinto, Robert</dc:creator>
	<dc:creator>Suwarto, Suhendro</dc:creator>
	<dc:creator>Widodo, Djoko</dc:creator>
	<dc:subject xml:lang="en-US">central venous oxygen saturation</dc:subject>
	<dc:subject xml:lang="en-US">early mortality</dc:subject>
	<dc:subject xml:lang="en-US">lactate clearance</dc:subject>
	<dc:subject xml:lang="en-US">sepsis</dc:subject>
	<dc:subject xml:lang="en-US">septic shock</dc:subject>
	<dc:subject xml:lang="en-US">infection</dc:subject>
	<dc:description xml:lang="en-US">Background: lactate clearance and central venous oxygen saturation (ScvO2) are two methods for determining tissue oxygenation adequacy. There is a controversy regarding method better associates with and predicts sepsis and septic shock patients’ mortality. This study address the association of achieving one or two targets of microcirculatory resuscitation endpoints and early mortality in sepsis and septic shock. Methods: a cohort study was conducted in adult sepsis and septic shock patients in Intensive Care Unit, Cipto Mangunkusumo Hospital, Indonesia. Patients’ resuscitation endpoints data and outcome were observed during the first 120 hours of hospitalization. Cox’s proportional hazard regression analysis was used to analyse the early mortality risk in subject groups achieving lactate clearance target only, ScvO2 target only, both targets, and not achieving any target in 6 hours after onset of resuscitation adjusted for number of organ dysfunction. Results: subjects consisted of 268 patients. There were significant differences in the mortality risk between subjects who achieved both targets with subjects who achieved ScvO2 target only (adjusted hazard ratio [aHR] 13.47; 95% confidence interval [CI] 5.17-35.08) and subjects who not achieve any target (aHR 16.12; 95%CI 7.43-34.95). There were insignificant difference the early mortality risk between subjects who achieved both targets with subjects achieved lactate clearance target only (aHR 2.29; 95%CI 0.83-6.32). Conclusion: in patients with sepsis and septic shock, achievement of lactate clearance and ScvO2 targets associates with similar early mortality risk compared to achievement of lactate clearance target only. However, it associates with lower early mortality risk compared with ScvO2 target only.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2019-01-11</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">Cohort retrospective</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/514</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 50 No. 4 (2018): Acta Medica Indonesiana; 275</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/514/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2019 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>