Stephens DP

Fisher DA

Currie BJ

2002-04

Granulocyte colony-stimulating factor (G-CSF) stimulates the production of neutrophils and modulates the function and activity of developing and mature neutrophils. In septic shock, the immune system can be considered one of the failing organ systems. G-CSF improves immune function and may be a useful adjunctive therapy in patients with septic shock. To evaluate the introduction of G-CSF as an adjunct to our standard treatment for community-acquired septic shock. We performed a prospective data collection and analysis to determine whether the addition of G-CSF to our standard treatment for community-acquired septic shock was associated with improved hospital outcome, compared with an historical cohort of similar patients. We included all patients admitted to the Intensive Care Unit (ICU) with community-acquired septic shock between December 1998 and March 2000. Patients received 300 microg G-CSF intravenously daily for 10 days in addition to our standard treatment for community-acquired septic shock. G-CSF was discontinued early if the patient was discharged from ICU before 10 days or if the absolute neutrophil count exceeded 75 x 10(6)/mL. A total of 36 patients with community-acquired septic shock, an average Apache 2 score of 26.7, and a predicted mortality of 0.79, were treated with G-CSF from December 1998 to March 2000. Hospital mortality was 31% compared with an historical cohort of 11 similar patients with a hospital mortality of 73% (P = 0.018). In the subgroup of patients with melioidosis septic shock, the hospital survival improved from 5% to 100% (P < 0.0001). No significant adverse events occurred as a result of the administration of G-CSF. G-CSF is a safe adjunctive therapy in community-acquired septic shock and may be associated with improved outcome. The use of G-CSF in septic shock should undergo further investigation to define subgroups of patients who may benefit from G-CSF. The use of G-CSF in patients with septic shock due to Burkholderia pseudomallei is recommended.

Internal medicine journal 2002-04; 32(4): 143-8

1444-0903

https://pubmed.ncbi.nlm.nih.gov/11951925/?otool=iaurydwlib

https://hdl.handle.net/10137/6812

Adolescent

Adult

Aged

Aged, 80 and over

Anti-Bacterial Agents

Australia

Chemotherapy, Adjuvant

Cohort Studies

Community-Acquired Infections

Critical Care

Drug Therapy, Combination

Female

Granulocyte Colony-Stimulating Factor

Hospital Mortality

Humans

Intensive Care Units

Male

Middle Aged

Prospective Studies

Reference Values

Severity of Illness Index

Shock, Septic

Survival Rate

Treatment Outcome

Medical Audit

An audit of the use of granulocyte colony-stimulating factor in septic shock.

Comparative Study

Journal Article

Publication