MYOCARDIAL DYSFUNCTION IN SEPSIS PATIENTS
https://doi.org/10.21292/2078-5658-2016-13-6-59-63
Abstract
Goal of the study: to study the frequency of myocardial dysfunction in sepsis patients and its impact on the outcome of the disease. Materials and Methods. 177 sepsis patients were enrolled into the retrospective cohort study. Myocardial dysfunction was diagnosed by transthoracic ultrasonic cardiography in 28% of patients. Results. According to the findings of the study myocardial dysfunction does not increase in-hospital mortality but increases the duration of artificial pulmonary ventilation (APV), vasopressor support and duration of stay in the intensive care department and general hospital stay. Reduction of left ventricle discharge less than 45% and increase of end diastolic size of the left ventricle are unfavorable prognostic factors for sepsis patients. Conclusions. Myocardial dysfunction is diagnosed in 28% of sepsis patients. Its development does not increase the rate of hospital mortality, but increases the duration of APV, vassopressor/inotropic support and duration of stay in the intensive care department and general hospital stay.
About the Authors
L. L. Plotkin
Chelyabinsk Regional Clinical Hospital, Chelyabinsk;
South Ural State Medical University, Chelyabinsk
Russian Federation
Doctor of Medical Sciences, Leading Intensive Care Physician
Russian Federation
Doctor of Medical Sciences, Leading Intensive Care Physician
M. Yu. Rakhmanov
Chelyabinsk Regional Clinical Hospital, Chelyabinsk
Russian Federation
Head of Purulent Intensive Care Department
Russian Federation
Head of Purulent Intensive Care Department
V. V. Kutubulatov
Chelyabinsk Regional Clinical Hospital, Chelyabinsk
Russian Federation
Intensive Care Physician of Purulent Intensive Care Department
Russian Federation
Intensive Care Physician of Purulent Intensive Care Department
References
1. Sergeenko V.I., Bondareva I.B. Matematicheskaya statistika v klinicheskikh issledovaniyakh. [Mathematical statistics for clinical trials]. Moscow, GEOTAR Meditsina Publ., 2000, 176 p.
2. Charlson M.E., Pompei P., Ales K.L. et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J. Chron. Dis., 1987, vol. 40, pp. 373-383.
3. Dellinger R.P., Levy M.M., Rhodes A. et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2012, Crit. Care Med., 2013, vol. 41, pp. 580-637.
4. Garzotto F., Ostermann M., Martín-Langerwerf D. et al. The Dose Response Multicentre Investigation on Fluid Assessment (DoReMIFA) in critically ill patients. Crit. Care, 2016, vol. 20, pp. R196.
5. Knaus W.A., Sun Х., Nystorm Р-O., Wagner D.P. Evolution of definitions for sepsis. Chest, 1992, vol. 101, pp. 1652-1662.
6. Metrangolo L., Fiorillo M., Fridman G. et al. Early hemodynamic course of septic shock. Crit. Care Med., 1995, vol. 23, no. 12, pp. 1971-1975.
7. Oquiber F.P., Parker M.M., Natanson Ch. et al. Depressed left ventricular performance. Chest, 1988, vol. 93, pp. 903-910.
8. Parker M.M., Shelhamer J.H. Profund but reversible myocardial depression in patients with septic shock. Ann. Intern. Med., 1984, vol. 100, pp. 483-490.
9. Potz B.A., Sellke F.W., Abid M.R. Endothelial ROS and impaired myocardial oxygen consumption in sepsis-induced cardiac dysfunction. Int. Crit. Care, 2016, vol. 2, no. 1, pp. 20–32.
10. Pulido J.N., Afessa B., Masaki M. et al. Clinical spectrum, frequency, and significance of myocardial dysfunction in severe sepsis and septic shock. Mayo Clin. Proc., 2012, vol. 87, no. 7, pp. 620.
11. Rolando G., Daniel E., Espinoza V. et al. Prognostic value of ventricular diastolic dysfunction in patients with severe sepsis and septic shock. Rev. Bras. Ter. Intensiva, 2015, 27, no. 4, pp. 333-339.
12. Samoni S., Valentina Vigo V., Reséndi I. G. et al. Impact of hyperhydration on the mortality risk in critically ill patients admitted in intensive care units: comparison between bioelectrical impedance vector analysis and cumulative fluid balance recording. Crit. Care, 2016, vol. 20, pp. 95-107.
13. Sato R . Kuriyama A., Takada T. et al. Prevalence and risk factors of sepsis-induced cardiomyopathy: A retrospective cohort study. Medicine (Baltimore), 2016, 95(39):e5031. doi: 10.1097/MD.0000000000005031.
14. Sato R., Nasu M. A review of sepsis-induced cardiomyopathy. J. Intens. Care, 2015, no. 3, pp. 1-7.
15. Singer M., Deutschman C.S., Seymour C.W. et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis–3). JAMA, 2016, vol. 315, no. 8, pp. 801-810.
16. Tatara T. Context-sensitive fluid therapy in critical Illness. Intens. Care, 2016, vol. 4, pp. 2-12.
17. Vincent J.-L., de Backer D. Circulatory shock. N. Engl. J. Med., 2013, vol. 369, pp. 1726-1734.
18. Vincent J.-L., de Mendonsa A., Cantraine T. et al. Use SOFA scores to assess the incichece of organ dysfunction failure in intensive care units: results of a multicenter, prospective study. Working group on’ sepsis problems of the European Society of Intensive Care. Crit. Care Med., 1998, vol. 26, pp. 1793-1800.
19. Zaky A., Deem S., Bendjelid J., Treggiari M.M. Characterization of cardiac dysfunction in sepsis: an ongoing challenge. Shock, 2014, vol. 41, pp. 12-24.
Review
For citations:
Plotkin L.L., Rakhmanov M.Yu., Kutubulatov V.V. MYOCARDIAL DYSFUNCTION IN SEPSIS PATIENTS. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2016;13(6):59-63. (In Russ.) https://doi.org/10.21292/2078-5658-2016-13-6-59-63
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