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CHEST 2013: Hypotension in ED Sepsis Patients

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The Particulars: The ability to predict hypotension among patients with severe sepsis or septic shock who are normotensive at ED triage may allow for more expeditious and appropriate treatment. The incidence and predictors of hypotension among this patient population have not been established in studies.

Data Breakdown: In an investigation of patients presenting to an ED with severe sepsis or septic shock and normal blood pressure (BP), 64.1% developed hypotension while in the ED. The average time from initial vital sign measurement to hypotension was 152.8 minutes. Patients who developed hypotension had lower initial mean arterial pressure levels and absolute neutrophil counts than those who did not. The authors noted, however, that there were no significant differences between groups in multiple measurements.

Take Home Pearls: Among patients with severe sepsis or septic shock who have normal BP at ED triage, about two-thirds appear to become hypotensive while still in the ED. This patient population may benefit from frequent BP measurements.

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