Evaluating the outcomes of Sudanese septic patients who necessitated invasive mechanical ventilation

Gwahir Ebrahim Osman IbnIdriss, Abdelwahid Ali Abdelwahid Mohamed, Tarig Elhadi Elsideeg Mahmoud, Mohammed Ahmed Ibrahim Ahmed, N. Abdelrahman, S. Osman, Isam Eldeen Eltayeb Osman Ali, Abderrhman Ahmed Mohamed Ismaeil
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Abstract

Background: Sepsis is a complicated disorder highlighted by the concurrent acceleration of coagulation and inflammation as a consequence of microbial assault. It has an important influence on hospitalized patients' need for mechanical ventilation and ICU admission. Objectives: The study's primary goal is to determine whether septic patients who require invasive mechanical ventilation fared well and whether their clinical condition improved or worsened after being connected to mechanical ventilation. The research also attempts to evaluate how additional medical interventions and other comorbidities affect the patient's prognosis. Material and methods: From November 2017 to May 2018, 160 patients with severe sepsis or septic shock were taken part in a prospective cross-sectional trial. The information was gathered using a straightforward, standardized questionnaire that included questions regarding the admission, progress, and outcome of septic patients who received mechanical ventilation in an intensive care unit. Results: 58 (36%) of the 160 patients were female, with 102 (64%) of the patients being male. In the age range of 60 to 70 years, 41 of them (or 25.6%) were detected. The majority of patients (59/369) had sepsis from a chest infection. Most of the patients, 87 (54.4%), got a combination of midazolam and fentanyl for sedation and analgesia. The majority of the patients, 85 (53%) had SIM/PS ventilation. Ultimately, 71 patients (44.4%) died, 80 patients (50%) were extubated, and 9 patients (5.6%) remained stationary and had a tracheostomy. Additionally, age, reasons, sedative type, and duration of stay were all substantially linked with the MV consequences (P 0.05). Conclusion: The better the outcome, the earlier septic patients who need IMV were identified and attached to IMV. It has been demonstrated that receiving IMV decreased mortality in septic patients by around 50%. The findings suggest that this intervention should be made more widely available and more reasonably priced by the authorities, along with the training of additional staff and the development of standard protocols for treating patients with such a condition. Focusing on health education awareness, establishing a focused outpatient department, and promptly screening patients who necessitate early referral to a tertiary care facility are the three most crucial aspects.
评估苏丹脓毒症患者需要有创机械通气的结果
背景:脓毒症是一种复杂的疾病,突出表现为微生物攻击导致凝血和炎症同时加速。它对住院患者机械通气需求和ICU住院有重要影响。目的:本研究的主要目的是确定需要有创机械通气的脓毒症患者是否预后良好,以及他们的临床状况在机械通气后是否得到改善或恶化。该研究还试图评估额外的医疗干预和其他合并症如何影响患者的预后。材料与方法:2017年11月至2018年5月,160例严重脓毒症或感染性休克患者参与前瞻性横断面试验。信息收集使用一个简单的,标准化的问卷调查,包括关于在重症监护病房接受机械通气的脓毒症患者的入院,进展和结果的问题。结果:160例患者中女性58例(36%),男性102例(64%)。在60 ~ 70岁年龄组中检出41例,占25.6%。大多数患者(59/369)因胸部感染而败血症。87例(54.4%)患者采用咪达唑仑联合芬太尼镇静镇痛。大多数患者85例(53%)采用SIM/PS通气。最终,71例患者(44.4%)死亡,80例患者(50%)拔管,9例患者(5.6%)保持静止并行气管切开术。此外,年龄、原因、镇静类型和住院时间均与MV后果有显著相关性(p0.05)。结论:越早发现需要静脉注射的脓毒症患者并给予静脉注射,治疗效果越好。已证明,接受IMV可使脓毒症患者的死亡率降低约50%。调查结果表明,当局应更广泛地提供这种干预措施,并使其价格更合理,同时培训更多的工作人员,并制定治疗此类患者的标准方案。注重健康教育意识,建立有针对性的门诊部,及时筛查需要早期转诊到三级保健机构的患者是最关键的三个方面。
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