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Clinical predictors for septic shock in patients with ventilator-associated pneumonia


Ventilator-associated pneumonia (VAP) is one of the most frequent infections of ICUs, and nearly 50% of patients develop septic shock during VAP. Septic shock is an independent predictor for mortality in these patients. The aim of this study is to investigate the predictors for septic shock in patients with VAP receiving appropriate antibiotic therapy.


Eighty-nine patients with microbiologically confirmed VAP and receiving appropriate antibiotic therapy were included in the study. The patients were divided into two groups according to the existence of septic shock. Clinical, hematological, biochemical and microbiological characteristics of the patients were compared.


Thirty-one percent of the patients developed septic shock, and advanced age (OR = 1.07, 95% CI = 1.02–1.13, P = 0.009), lymphocytopenia <1,000 mm3 (OR = 7.48, 95% CI = 1.91–29, P = 0.004), high blood glucose levels >120 mg/dl (OR = 4.75, 95% CI = 1.38–16, P = 0.014), and higher Clinical Pulmonary Infection Scores (OR = 1.64, 95% CI = 1.16–2.33, P = 0.006) were independent predictors for the development of septic shock.


Some clinical parameters such as lymphocytopenia, advanced age, higher blood glucose levels and Clinical Pulmonary Infection Scores can predict septic shock during VAP but large randomized controlled studies are needed to confirm these results.

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Gursel, G., Aydogdu, M. Clinical predictors for septic shock in patients with ventilator-associated pneumonia. Crit Care 12 (Suppl 2), P55 (2008).

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