Intensive care unit outcome versus haemodynamic status on arrival at a general intensive care unit

Introduction

Goal-directed therapeutic protocols such as that described by Rivers and colleagues [1] have taken an important place in efforts to increase survival in septic patients. We looked at ICU outcomes for patients meeting the haemodynamic criteria of the Rivers trial on admission to our general ICU.

Methods

We prospectively recorded haemodynamic parameters of 98 consecutive patients admitted to a mixed medical/surgical ICU and compared these with the ICU outcome. Patients who met systemic inflammatory response syndrome (SIRS) criteria [2] and had lactate ≥4 mmol/l or systolic blood pressure ≤90 mmHg met the Rivers criteria.

Results

We included 98 patients admitted to the ICU (60 males) of mean age 61 ± 17 years. Fourteen patients (14%) died in the ICU, and the median length of stay was 3 (IQR 3) days. Overall 16 of the 98 patients met the Rivers criteria, four of whom died (25%). The median length of ICU stay for the Rivers patients was 5 (1.25) days (see Table 1).

Table 1 abstract P7

Conclusion

Sixteen out of 98 patients (16%) met Rivers criteria. Of medical and surgical emergency patients, this proportion rose to 16 of 55 patients (29%).