左心室舒张功能障碍与脓毒症患者肺水肿无关。一项前瞻性观察队列研究。
Left Ventricular Diastolic Dysfunction Is Not Associated With Pulmonary Edema in Septic Patients. A Prospective Observational Cohort Study.
作者信息
Kahl Ursula, Schirren Leah, Yu Yuanyuan, Lezius Susanne, Fischer Marlene, Menke Maja, Sinning Christoph, Nierhaus Axel, Vens Maren, Zöllner Christian, Kluge Stefan, Goepfert Matthias S, Roeher Katharina
机构信息
Klinik und Poliklinik für Anästhesiologie Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Institut für Medizinische Biometrie und Epidemiologie Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
出版信息
Front Cardiovasc Med. 2022 Jul 1;9:900850. doi: 10.3389/fcvm.2022.900850. eCollection 2022.
PURPOSE
We aimed to investigate whether left ventricular diastolic dysfunction (LVDD) is associated with pulmonary edema in septic patients.
METHODS
We conducted a prospective cohort study in adult septic patients between October 2018 and May 2019. We performed repeated echocardiography and lung ultrasound examinations within the first 7 days after diagnosis of sepsis. We defined LVDD according to the 2016 recommendations of the American Society of Echocardiography and-for sensitivity analysis-according to an algorithm which has been validated in septic patients. We quantified pulmonary edema using the lung ultrasound score (LUSS), counting B-lines in four intercostal spaces.
RESULTS
We included 54 patients. LVDD was present in 51 (42%) of 122 echocardiography examinations. The mean (±SD) LUSS was 11 ± 6. There was no clinically meaningful association of LVDD with LUSS ( = 0.55 [95%CI: -1.38; 2.47]; = 0.571). Pneumonia was significantly associated with higher LUSS ( = 4.42 [95%CI: 0.38; 8.5]; = 0.033).
CONCLUSION
The lack of a clinically meaningful association of LVDD with LUSS suggests that LVDD is not a major contributor to pulmonary edema in septic patients.
TRIAL REGISTRATION
NCT03768752, ClinicalTrials.gov, November 30, 2018 - retrospectively registered.
目的
我们旨在研究左心室舒张功能障碍（LVDD）是否与脓毒症患者的肺水肿相关。
方法
我们在2018年10月至2019年5月期间对成年脓毒症患者进行了一项前瞻性队列研究。在脓毒症诊断后的前7天内，我们进行了重复的超声心动图和肺部超声检查。我们根据美国超声心动图学会2016年的建议定义LVDD，并为进行敏感性分析，根据一种已在脓毒症患者中得到验证的算法进行定义。我们使用肺部超声评分（LUSS）对肺水肿进行量化，计算四个肋间空间的B线数量。
结果
我们纳入了54例患者。在122次超声心动图检查中，有51例（42%）存在LVDD。LUSS的平均值（±标准差）为11±6。LVDD与LUSS之间没有具有临床意义的关联（β = 0.55 [95%CI：-1.38；2.47]；P = 0.571）。肺炎与较高的LUSS显著相关（β = 4.42 [95%CI：0.38；8.5]；P = 0.033）。
结论
LVDD与LUSS之间缺乏具有临床意义的关联表明，LVDD不是脓毒症患者肺水肿的主要促成因素。
试验注册
NCT03768752，ClinicalTrials.gov，2018年11月30日 - 回顾性注册。
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