Sepsis and Septic Shock

Boller, Elise Mittleman; Otto, Cynthia M.

doi:10.1016/b978-1-4557-0306-7.00091-x

Cited by 13 publications

(17 citation statements)

References 83 publications

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“…The cohort of septic patients within this study population was small and the survival rate of septic dogs was high (71.4%). Previously reported survival rates in dogs with sepsis range from 20% to 68% (Mittleman Boller & Otto 2015). Since the score was not evaluated alongside other validated illness severity scores in dogs, it is not possible to correlate how this score compares to other previously evaluated measures of critical illness in dogs (SPI2, APPLE, SOFA), and that remains a limitation of this study.…”

Section: Discussionmentioning

confidence: 96%

“…Additional information recorded included patient signalment, age, diagnosis, and outcome. A diagnosis of sepsis was made if a patient had evidence of SIRS plus a documented or suspected infection (Mittleman Boller & Otto 2015, Sharp 2019, as diagnosed by cytology, culture, or suspicion based on clinical assessment. Additional disease processes evaluated from the data set included congestive heart failure, pneumonia, and pancreatitis.…”

Section: Methodsmentioning

confidence: 99%

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Evaluation of the quick sequential organ failure assessment score plus lactate in critically ill dogs

Ortolani¹,

Bellis²

2021

J of Small Animal Practice

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To apply the quick sequential organ failure assessment (qSOFA) score to dogs admitted to a veterinary ICU, and evaluate whether the addition of lactate increased the predictive ability of the score. Materials and MethOds:A quick sequential organ failure assessment score of 0, 1, 2, or 3 was assigned to each dog based on the following criteria: respiratory rate >22 breaths per minute, altered mentation, systolic blood pressure <100 mmHg. Lactate was added to quick sequential organ failure assessment in an LqSOFA model and assigned to each patient. Disease processes evaluated included sepsis, congestive heart failure, pneumonia and pancreatitis. results: Two hundred and sixty-seven client-owned dogs met the inclusion criteria. There was no significant difference in quick sequential organ failure assessment score between survivors and non-survivors. The use of lactate >3, 4, and 5 mmol/L incorporated into the quick sequential organ failure assessment score (L3qSOFA, L4qSOFA, L5qSOFA) distinguished between survival and non-survival (AUC=0.62; AUC=0.64; AUC=0.62, respectively). Lactate alone distinguished between survival and non-survival (AUC=0.63). Lactate concentration was significantly lower in survivors.clinical significance: In this study, quick sequential organ failure assessment was not able to predict survival in a general population of critically ill patients. The addition of lactate to the quick sequential organ failure assessment score slightly increased the predictive ability of the score.

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Section: Discussionmentioning

confidence: 96%

Section: Methodsmentioning

confidence: 99%

Evaluation of the quick sequential organ failure assessment score plus lactate in critically ill dogs

Ortolani¹,

Bellis²

2021

J of Small Animal Practice

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“…Collection of blood cultures is routinely performed in septic humans (Dellinger et al . ) and is recommended in septic veterinary patients (Boller & Otto ). Upon documentation of neutropaenia and prior to the availability of blood culture results, broad‐spectrum antibiotics are typically initiated in febrile, neutropaenic patients.…”

Section: Discussionmentioning

confidence: 99%

Prospective study evaluating the incidence of bacteraemia and bacteruria in afebrile and febrile neutropaenic dogs undergoing chemotherapy

Shaffer

Bach

Chun

2016

Veterinary Medicine & Sci

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The purpose of this prospective study was to determine the incidence and character of bacteraemia and bacteruria in afebrile and febrile neutropaenic dogs undergoing cytotoxic chemotherapy. Fifty‐five neutropaenic dogs presenting to the University of Wisconsin Veterinary Medical Teaching Hospital were enrolled for a total of 57 neutropaenic episodes. The overall incidence of bacteraemia was 12.3% (n = 7/57). Three afebrile dogs and four febrile dogs were bacteraemic; this difference was not significant (P = 0.6968). The overall incidence of bacteruria was 7.5% (n = 4/53). Two afebrile dogs and two febrile dogs were bacteruric; this difference was not significant (P = 1.0). Of the positive blood cultures, the majority of organisms cultured (n = 6/7) were gram‐positive organisms with one gram‐negative organism. Three of the positive blood cultures showed in vitro resistance to more than one antimicrobial agent. Clinical parameters (age, body weight, heart rate, rectal temperature, neutrophil count, haematocrit and platelet count) were not predictive of bacteraemia. The results of this study were not sufficient to justify the use of blood cultures as a first‐line diagnostic test for neutropaenic patients. Blood cultures may have utility in individual case management for a minority of patients in guiding antibiotic choice in the case of resistant bacterial infections. Blood cultures may serve as a tool for antimicrobial de‐escalation, although further study is needed.

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“…However, in veterinary medicine, the definitions remain consistent with the initial 1991 definition, which defines sepsis as SIRS with an infectious nidus (Kenney et al . 2010, Boller & Otto 2014, Sharp 2019).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock

Osgood

Hollenbeck

Yankin

2022

J of Small Animal Practice

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To evaluate the prognostic utility of the quick sequential organ failure assessment score in dogs with severe sepsis and septic shock presenting to an emergency service, and evaluate the clinical value of the quick sequential organ failure assessment score to predict severe sepsis and septic shock. Materials and MethOds:The quick sequential organ failure assessment score was calculated by evaluating respiratory rate (>22 breaths per minute), arterial systolic blood pressure (≤100 mmHg) and altered mentation. The quick sequential organ failure assessment scores with respiratory rate cut-offs of greater than 22, greater than 30 and greater than 40 were compared. Cases were defined as dogs presented to the emergency room and met at least 2 systemic inflammatory response syndrome criteria, had documented infection, and at least one organ dysfunction. A control population of dogs included animals with non-infectious systemic inflammatory response syndrome.results: Forty-five dogs with severe sepsis and septic shock and 45 dogs with non-infectious systemic inflammatory response syndrome were included in the final analysis. The quick sequential organ failure assessment provided poor discrimination between survivors and non-survivors for severe sepsis and septic shock (area under receiving operating characteristic curve, 0.51; 95% confidence interval, 0.35 to 0.67). Discrimination remained poor when quick sequential organ failure assessment greater than 30 and quick sequential organ failure assessment greater than 40 scores were calculated (area under receiving operating characteristic curve, 0.56; 95% confidence interval, 0.39 to 0.72, and 0.54; 95% confidence interval, 0.36 to 0.71). The quick sequential organ failure assessment of at least 2, quick sequential organ failure assessment greater than 30 of at least 2 and quick sequential organ failure assessment greater than 40 of at least 2 produced sensitivity and specificity to detect severe sepsis and septic shock of 66. 7% and 64.5%, 62.2% and 71.1%, 44.4% and 80%, respectively. cOnclusiOn and clinical significance: Scoring systems utilised in emergency rooms should have high sensitivity to reduce missed sepsis cases and treatment delays. The use of the quick sequential organ failure assessment for severe sepsis and septic shock demonstrated poor mortality prediction and low sensitivity to detect canine patients with severe sepsis and septic shock and should not be used alone when screening for sepsis.

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Sepsis and Septic Shock

Cited by 13 publications

References 83 publications

Evaluation of the quick sequential organ failure assessment score plus lactate in critically ill dogs

Evaluation of the quick sequential organ failure assessment score plus lactate in critically ill dogs

Prospective study evaluating the incidence of bacteraemia and bacteruria in afebrile and febrile neutropaenic dogs undergoing chemotherapy

Evaluation of quick sequential organ failure scores in dogs with severe sepsis and septic shock

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