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Response to a Letter to the Editor
YJCRC-52437; No of Page 1 Journal of Critical Care xxx (2017) xxx
Contents lists available at ScienceDirect
Journal of Critical Care journal homepage: www.jccjournal.org
Response to a Letter to the Editor
References [1] Moskowitz A, Omar Y, Chase M, Lokhandwala S, Patel P, Andersen LW, et al. Reasons for death in patients with sepsis and septic shock. J Crit Care 2017;38:284–8.
To the Editor: We appreciate the insightful comments made by Dr. Jo and colleagues with regard to our article, “Reasons for death in patients with sepsis and septic shock” [1] and the opportunity to respond to their concerns. As Dr. Jo notes, the most common origin of infection in our cohort was pulmonary. Of those patients with a pulmonary source of infection, Refractory Hypoxemia accounted for 22.0% of deaths (as determine by Reviewer #2). In contrast, none of the patients with extra-pulmonary origins of infection had a reason for death characterized as Refractory Hypoxemia. Similarly, reviewers #1 and #3 found that no patients with an extra-pulmonary origin of infection expired as a result of Refractory Hypoxemia. Refractory Shock was a less commonly selected reason for death amongst patients with a pulmonary origin of infection as compared to those with an extra-pulmonary origin (24.0% vs. 52.3%, Reviewer #2). Sudden Cardiac Arrest was selected as the reason for death in 2.0% of cases where infection was of pulmonary origin and 4.6% of cases where the infection was of extra-pulmonary origin. As noted by Dr. Jo and colleagues, and demonstrated by the above data, the relative frequency of different reasons for death appears to vary by site of infection origin. While perhaps intuitive, these findings serve to underscore the heterogeneity of patients encompassed within the sepsis syndrome. We encourage further research in this area and recommend that clinicians and investigators consider how the site of infection might influence reasons for death when caring or designing studies for patients with sepsis and septic shock.
Ari Moskowitz Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Parth Patel Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Michael W. Donnino Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Corresponding author at: Beth Israel Deaconess Medical Center, Emergency Medicine, One Deaconess Rd, W/CC 2, Boston, MA 02215, United States. E-mail address: [email protected].
Available online xxxx
http://dx.doi.org/10.1016/j.jcrc.2017.02.037 0883-9441/© 2017 Published by Elsevier Inc.
Please cite this article as: Moskowitz A, et al, Response to a Letter to the Editor, Journal of Critical Care (2017), http://dx.doi.org/10.1016/ j.jcrc.2017.02.037
Contents lists available at ScienceDirect
Journal of Critical Care journal homepage: www.jccjournal.org
Response to a Letter to the Editor
References [1] Moskowitz A, Omar Y, Chase M, Lokhandwala S, Patel P, Andersen LW, et al. Reasons for death in patients with sepsis and septic shock. J Crit Care 2017;38:284–8.
To the Editor: We appreciate the insightful comments made by Dr. Jo and colleagues with regard to our article, “Reasons for death in patients with sepsis and septic shock” [1] and the opportunity to respond to their concerns. As Dr. Jo notes, the most common origin of infection in our cohort was pulmonary. Of those patients with a pulmonary source of infection, Refractory Hypoxemia accounted for 22.0% of deaths (as determine by Reviewer #2). In contrast, none of the patients with extra-pulmonary origins of infection had a reason for death characterized as Refractory Hypoxemia. Similarly, reviewers #1 and #3 found that no patients with an extra-pulmonary origin of infection expired as a result of Refractory Hypoxemia. Refractory Shock was a less commonly selected reason for death amongst patients with a pulmonary origin of infection as compared to those with an extra-pulmonary origin (24.0% vs. 52.3%, Reviewer #2). Sudden Cardiac Arrest was selected as the reason for death in 2.0% of cases where infection was of pulmonary origin and 4.6% of cases where the infection was of extra-pulmonary origin. As noted by Dr. Jo and colleagues, and demonstrated by the above data, the relative frequency of different reasons for death appears to vary by site of infection origin. While perhaps intuitive, these findings serve to underscore the heterogeneity of patients encompassed within the sepsis syndrome. We encourage further research in this area and recommend that clinicians and investigators consider how the site of infection might influence reasons for death when caring or designing studies for patients with sepsis and septic shock.
Ari Moskowitz Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Parth Patel Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Michael W. Donnino Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States Corresponding author at: Beth Israel Deaconess Medical Center, Emergency Medicine, One Deaconess Rd, W/CC 2, Boston, MA 02215, United States. E-mail address: [email protected].
Available online xxxx
http://dx.doi.org/10.1016/j.jcrc.2017.02.037 0883-9441/© 2017 Published by Elsevier Inc.
Please cite this article as: Moskowitz A, et al, Response to a Letter to the Editor, Journal of Critical Care (2017), http://dx.doi.org/10.1016/ j.jcrc.2017.02.037