1. [Myocardial dysfunction and its prognostic utility in sepsis and septic shock].
- Author
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Delgado-Serrano JF, Torres-Cordón M, Peña-Rangel MA, Torres-Langhammer MP, Useche-Traslaviña CA, Duarte H, Serrano-Gómez S, and Torres-Dueñas D
- Subjects
- Cross-Sectional Studies, Humans, Prognosis, Prospective Studies, Stroke Volume, Ventricular Function, Left, Sepsis complications, Sepsis diagnosis, Shock, Septic diagnosis
- Abstract
Background: Sepsis is a potentially mortal infection which is related to multiple organ dysfunction; it has a high morbidity and mortality. Myocardial dysfunction is frequent in sepsis and it is related to unfavorable outcomes. Objective: To describe by transthoracic echocardiography the clinical distribution of myocardial dysfunction in sepsis and septic shock and estimate its prognostic utility., Material and Methods: Cross-sectional study based on a multi-centric prospective cohort study in 4 reference centers in Bucaramanga, Colombia, and its metropolitan area. 271 patients with sepsis and septic shock were included; they underwent standard transthoracic echocardiography and a 30-day follow-up., Results: There was no difference in the left ventricular ejection fraction (p = 0.061) between survivors and non-survivors. 51 patients (48.71%) had grade I diastolic dysfunction, 48 patients (14.52%) had grade II dysfunction and 21 patients (36.75%) had grade III diastolic dysfunction. Mortality was higher in patients with grade I diastolic dysfunction when compared to those with grade II dysfunction (p = 0.023)., Conclusions: The higher mortality in grade I diastolic dysfunction suggests that patients with low filling pressures have worst outcomes. On the other hand, left ventricular ejection fraction per se is not associated with a higher mortality in sepsis., (© 2021 Instituto Mexicano del Seguro Social.)
- Published
- 2021