- Poster presentation
- Open Access
A better prognosis for septic patients with left ventricular dysfunction?
© BioMed Central Ltd. 2010
- Published: 1 March 2010
- Septic Shock
- Severe Sepsis
- Diastolic Dysfunction
- Septic Patient
- Left Ventricular Dysfunction
A retrospective study was conduced during 6 months (April to September 2009) in an ICU of a university tertiary hospital, identifying all patients with SSh or SeS and reviewing their echocardiographic data. All the patients with known or clinical/echocardiographic evidence of significant prior cardiac disease were excluded from this analysis.
Forty-nine patients were identified with SSh or SeS from a total of 211 ICU patients (23.2%). Among these, 26 had echocardiograms done during their ICU stay (53.1%). We analyzed 19 echocardiograms from 15 patients. The remaining 11 patients were excluded, having ischemic heart disease (seven patients) and significant valvular heart disease (four patients). Within the SSh/SeS group of patients, those with echocardiograms were younger (mean age 56.3 vs 64.4) and more often women (53.3% vs 36.7%). The ICU mortality was nevertheless similar in the two groups (46.7% vs 46.9%). The primary sites of infection were the lungs and abdomen (26.7% each) or unknown (20%). The agents most frequently isolated were Gram-negative bacilli (26.7%). In 53.3% of cases there was no identified agent. Echocardiographic evaluation revealed significant changes in 26.7% of the patients, with the remaining being considered normal. Of those with significant changes, 75% (n = 3) showed impairment of left ventricular (LV) systolic function with global hypokinesia simultaneously with diastolic dysfunction. Either abnormality was not found in any other patients. The mortality rate during ICU stay was lower in the group of patients with systolic and diastolic LV dysfunction compared with those with no apparent modification of LV function (0 vs 58.3%). The right ventricle was dilated and showed high systolic pressures present in only one patient.
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