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논문분류	춘계학술대회 초록집
제목	MANAGEMENT OF SEPTIC SHOCK PATIENTS WITH DIABETES MELLITUS II WITHOUT ICU ROOM AT SECONDARY HOSPITAL
저자	Rima Nur Rahmawati
출판정보	2020; 2020(1):
키워드	septic shock \| fluid therapy \| organ dysfunction \| diabetes mellitus type II
초록	Background: Septic is a host systemic response to infection. Septic term based on newest guideline is life threatening organ dysfunction caused by a dysregulated host response to infection. Organ dysfunction is defined as an increase of SOFA score ≥ 2. It is further known that septic shock is a major health problem because it has a high mortality and morbidity. Various attempts have been made by various clinicians and researchers around the world to reduce the mortality of septic patients, especially septic accompanied by impaired organ function. The immune response changes and susceptibility to infection increases in Diabetes Mellitus (DM) patients. People with DM are more likely to get infections. Subject and Methods: The subjects of this study is patients at Bhayangkara Pusdik Brimob Hospital, who entered through the emergency unit in 2020. Subjects were diagnosed with septic shock and DM type II by the doctors at emergency unit and were approved by an internist. Results: All patients with diagnoses of septic shock and DM type II come to the emergency unit with dyspnea and loss of consciousness. Respiratory rate all of patients are >35x/minute. In patients found organ dysfunction, with SOFA score ≥ 2. One patient presents with hypoglycaemia, but the others with hyperglycaemia with a value > 400 mg / dl. One patient came with an ulcer in genu + 6cm x 3cm accompanied by pus, and the other patients did not get an ulcer. All patients managed by fluid loading to overcome the shock condition, but they did not improve. Other study show that fluid therapy in septic shock will worsen the patient's condition. Conclusion: Management of septic shock patients is a complicated thing to do, especially in hospitals without ICU.
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