Date of Award

2018-05-23

Degree Name

PhD Nursing

Dissertation Committee

Ann M. Mayo, DNSc, RN, FAAN, Chairperson; Ruth A. Bush, PhD, MPH; Kathleen M. Stacy, PhD, APRN-CNS

Keywords

mitochondrial dysfunction, cytopathic hypoxia, sepsis, oxygen consumption, serum lactate, SOFA

Abstract

Background: Sepsis is a life-threatening condition that can lead to septic shock and death. With over 300,000 annual cases (AHRQ, 2011) costing a staggering $1.5 billion (Health Care Utilization Project Brief #185), the importance of sepsis is becoming clear. However, some basic biological mechanisms are poorly understood. Study Purpose: This study investigated the relationships between select demographics, resting energy expenditure (REE), serum lactate, SOFA score mortality index, oxygen consumption [by way of measuring net oxygen consumed, (V02) and net carbon dioxide produced (VC02)], and sepsis. Specific Aims: Aims were to describe 1) patient demographics, serum lactate, SOFA score mortality index, sepsis diagnosis, and 02 consumption; 2) the difference in oxygen consumption in ICU patients with and without a diagnosis of sepsis; 3a) the relationships between gender, age, REE, height, weight, lactate and VO2; 3b) the relationships between gender, age, REE, height, weight, lactate and VCO2; and 4) the relationships between age, gender, height, weight, VO2, VCO2, lactate, SOFA, REE, and sepsis Methods: Data for this quantitative descriptive feasibility study were accessed from two hospital databases. Results: For the total cases (N = 21) mean age was 71.2 years (+/- 14.1) and mostly female (71.4%). There was a difference in oxygen consumption between the two groups of cases (sepsis and non-sepsis) [VO2 (t 3.919, p 0.001), VC02 (η = 608, p = 0.003), and lactate (η = 621, p = 0.003). Implications: Nurses are at the forefront of monitoring patients with sepsis. While this study utilized a small sample size, significant relationships were found among a number of important clinical variables. Further research is needed utilizing larger samples to test predictive models for sepsis so that nurses can intervene to prevent the deterioration of these patients.

Document Type

Dissertation: Open Access

Department

Nursing

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