Effect of myocardial preservation of early goal-directed therapy on severe sepsis/septic shock patients in the ICU

Introduction

To investigate the effect of myocardial preservation of early goal-directed therapy (EGDT) on severe sepsis/septic shock patients in the ICU.

Methods

This is a prospective and randomized controlled study, in which the total 158 severe sepsis/septic shock patients from the ICU were randomly assigned into two groups (EGDT group, n = 81 and control group, n = 77). Then the concentration of serum cardiac troponin I (cTnI), high sensitivity C-reactive protein (hs-CRP) and APACHE II score of patients were obtained on the 0, 3rd, 7th, and 14th day after fluid resuscitation therapy.

Results

The levels of cTnI were the same between the EGDT and control groups on day 0 (exceeded normal cTnI patients in two groups 0.41 vs 0.42, normal cTnI patients in two groups 0.05 vs 0.04, P > 0.05), there was a dramatic decrease in exceeded normal cTnI patients of the EGDT group, in which cTnI returned to normal after EGDT (14th day: exceeded normal cTnI patients in two groups 0.08 vs 0.16, P < 0.05); however, only a little difference in normal cTnI patients of the two groups (P > 0.05). The level of hs-CRP changed like cTnI (P < 0.05), and there was positive correlation between cTnI and hs-CRP on each time (P < 0.05); APACHE II scores obviously decrease in the EGDT group (P < 0.05). Meanwhile, the EGDT group have an obviously higher 28-day survival rate and longer survival time than that of the control group (74.1% vs 55.8%; 23.5 vs 19.6, P < 0.05).

Conclusions

EGDT has an effect of myocardial preservation and improves the survival rate for severe sepsis/septic shock patients in the ICU.