Diastolic Dysfunction and Mortality in Early Severe Sepsis and Septic Shock - A Prospective Echocardiography Study
Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2018, Vol 6, Issue 1
Abstract
Background: Severe sepsis or septic shock is suggested to be a cause of significant cardiovascular dysfunction. Left ventricular diastolic dysfunction is common in septic patients. Aim: To evaluate the incidence of the diastolic dysfunction estimated by transthoracic echocardiography (TTE) and its related mortality rate in patients with severe sepsis or septic shock. Methods: We carried a prospective study on 80 patients with severe sepsis or septic shock. All the patients underwent TTE within 6 hours of ICU admission, after 18 to 32 hours and after resolution of shock. The study was carried out from January 2017 to December 2017 at Prathima Institute of Medical Sciences, Karimnagar, Telangana State, India. Left ventricular (LV) diastolic dysfunction was defined according to modified American Society of Echocardiography 2009 guidelines using E, A, and e’ velocities; E/A and E/e’; and E deceleration time. Systolic dysfunction was defined as an ejection fraction<45%. Results: The mean age of the patients was 50.6 ± 18.3 years. Out of 80 patients, 45 were female and 35 male. The mean Acute Physiology And Chronic Health Evaluation II (APACHE II) score was 21.6 ± 8.1. Initial echocardiogram revealed that 30 (37.5%) of patients had diastolic dysfunction, while 50 patients (62.5%) had diastolic dysfunction on at least one echocardiogram. Total mortality was 16 %. Grade I diastolic dysfunction, but not grades II and III, was associated with increased mortality. Conclusion: Left ventricular diastolic dysfunction is frequent in septic patients. There is a possible role for TTE in sepsis resuscitation.
Authors and Affiliations
Pabba Kylasam
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