• HyunSoo Oh, EunKyoung Bae, SeonYoung Lim, JiHye Oh, SunYoung Han, and WhaSook Seo.
• Department of Nursing, Inha University, Incheon, Korea.
• J Clin Nurs. 2016 Nov 1; 25 (21-22): 3176-3188.

Aims And ObjectivesThis study was conducted to determine temporal patterns of early changes in physiological parameters of systemic inflammatory response syndrome over three days prior to a diagnosis of sepsis.BackgroundEarly detection and timely management of systemic inflammatory response syndrome are often not implemented due to a failure to recognise or diagnose systemic inflammatory response syndrome.DesignA retrospective case-control study design was adopted.MethodsAll 81 study subjects in an intensive care unit were included: 33 case subjects who received a definitive diagnosis of sepsis and 48 control patients who were not diagnosed with systemic inflammatory response syndrome or sepsis. Vital signs (temperatures, heart rates, blood pressures and respiratory rates) and white blood cell count, urine output, serum creatinine concentration, platelet count and serum glucose level data were collected for one, two and three days prior to sepsis diagnosis.ResultsHomogeneity test revealed greater proportions of the aged and subjects with diabetes mellitus, hypertension and wound in the case group. Analysis also showed significant intergroup differences in systemic inflammatory response syndrome criteria score, heart rates, platelet counts and blood glucose levels, but no intergroup differences in body temperatures, blood pressures, respiratory rates, urine outputs or serum creatinine levels. A larger proportion of case subjects were fitted with a central venous or Foley catheter.ConclusionsThe presence of a wound, hypertension or diabetes mellitus, and the use of an invasive medical device may increase the risk of systemic inflammatory response syndrome. Of the physiological parameters examined, heart rate, platelet counts, and blood glucose levels might serve as significant early signs of systemic inflammatory response syndrome.Relevance To Clinical PracticeCaution should be observed whenever diabetic or hypertension patients develop sudden and persistent hyperglycaemia or tachycardia, and nurses should also be aware of the potential for systemic inflammatory response syndrome in patients with a central venous or indwelling urinary catheter.© 2016 John Wiley & Sons Ltd.

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