Bansal Sonali, Varshney Siddarth, Shrivastava Anupam
Department of Critical Care, SPS Hospital, Ludhiana, Punjab, India.
Department of Cardiology, CMC Hospital, Ludhiana, Punjab, India.
Indian J Crit Care Med. 2022 Jul;26(7):798-803. doi: 10.5005/jp-journals-10071-24204.
Sepsis leads to left and/or right ventricular systolic and/or diastolic dysfunction resulting in adverse outcomes. Myocardial dysfunction can be diagnosed by echocardiography (ECHO) and early intervention can be planned. There are lacunae in Indian literature regarding the true incidence of septic cardiomyopathy and its influence on the outcome of patients admitted to intensive care unit (ICU).
This prospective observational study was conducted on patients consecutively admitted with sepsis to the ICU of a tertiary care hospital in North India. In these patients, ECHO was performed after 48-72 hours to establish left ventricular (LV) dysfunction, in whom the ICU outcome was analyzed.
The incidence of LV dysfunction was 14%. About 42.86% of patients had isolated systolic dysfunction, 7.14% of patients had isolated diastolic dysfunction, and 50.00% of patients had combined LV systolic and diastolic dysfunctions. The average days of mechanical ventilation in patients without LV dysfunction group (group I) was 2.41 ± 3.82 days as compared to 4.43 ± 4.27 days in patients with LV dysfunction (group II) ( = 0.034). Incidence of all-cause ICU mortality was 11 (12.79%) in group I and 3 (21.43%) in group II ( = 0.409). The mean duration of stay in ICU was 8.26 ± 4.41 days in group I as compared to 13.21 ± 6.83 days in group II.
We concluded that sepsis-induced cardiomyopathy (SICM) in ICU is quite prevalent and clinically significant. All-cause ICU mortality and length of ICU stay are prolonged in patients with SICM.
Bansal S, Varshney S, Shrivastava A. A Prospective Observational Study to Determine Incidence and Outcome of Sepsis-induced Cardiomyopathy in an Intensive Care Unit. Indian J Crit Care Med 2022;26(7):798-803.
脓毒症可导致左心室和/或右心室收缩和/或舒张功能障碍,从而产生不良后果。可通过超声心动图(ECHO)诊断心肌功能障碍,并可据此制定早期干预措施。印度文献中关于脓毒症性心肌病的真实发病率及其对重症监护病房(ICU)患者预后的影响存在空白。
本前瞻性观察性研究针对印度北部一家三级医院ICU中连续收治的脓毒症患者进行。在这些患者中,48 - 72小时后进行ECHO以确定左心室(LV)功能障碍,并分析其ICU预后。
左心室功能障碍的发生率为14%。约42.86%的患者存在单纯收缩功能障碍,7.14%的患者存在单纯舒张功能障碍,50.00%的患者存在左心室收缩和舒张功能联合障碍。无左心室功能障碍组(I组)患者的平均机械通气天数为2.41±3.82天,而左心室功能障碍患者(II组)为4.43±4.27天(P = 0.034)。I组全因ICU死亡率为11例(12.79%),II组为3例(21.43%)(P = 0.409)。I组在ICU的平均住院时间为8.26±4.41天,II组为13.21±6.83天。
我们得出结论,ICU中脓毒症诱导的心肌病(SICM)相当普遍且具有临床意义。SICM患者的全因ICU死亡率和ICU住院时间会延长。
Bansal S, Varshney S, Shrivastava A. A Prospective Observational Study to Determine Incidence and Outcome of Sepsis-induced Cardiomyopathy in an Intensive Care Unit. Indian J Crit Care Med 2022;26(7):798 - 803.