• M Sukavejvorakit and K Tantivitayatan.
• Department of Medicine, Sawanpracharak Hospital, Nakornsawan, Thailand.
• Singap Med J. 1998 Jan 1; 39 (1): 14-6.

BackgroundNormalisation of heart rate after 24 hours of treatment is proposed to predict the survival outcome in septic shock patients.MethodsThe medical and surgical patients charts from 1991-1993 were selected for the diagnosis of septic shock (according to the definition of ACCP/SCCM Consensus Conference), and reviewed. Also included were patients with available variables to complete APACHE II and septic severity score.ResultsTachycardia was observed more in the non-survivors (9 patients) both in shock (107.8 vs 93.4) and non-shock states (112.3 vs 93.2). Heart rate in the survival group decreased below the cut-off value, which is 95 beats/min, as specified by ACCP/SCCM. Comparison between APACHE II and SSS was not well correlated because of the small sample size. Elements in creating a predictor and its categorisation are mentioned.ConclusionHeart rate was concluded to be a simple predictor reflecting physiologic derangements in septic shock. It is recommended that further study needs to be carried out to unravel a predictor of clinical value in terms of practicality, especially that involving the inflammatory aspect of the disease process.

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