Impact of New-Onset Left Ventricular Dysfunction on Outcomes in Mechanically Ventilated Patients With Severe Sepsis and Septic Shock

Background: Left ventricular systolic dysfunction (LVSD) and LV diastolic dysfunction (LVDD) are commonly seen in severe sepsis and septic shock; however, their role in patients with concurrent invasive mechanical ventilation (IMV) is less well defined. Methods: This was a prospective observational...

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Published in:Journal of intensive care medicine 2018-12, Vol.33 (12), p.680-686
Main Authors: Vallabhajosyula, Saraschandra, Gillespie, Shane M., Barbara, David W., Anavekar, Nandan S., Pulido, Juan N.
Format: Article
Language:English
Subjects:
Critical Care
Echocardiography
Hospital Mortality
Humans
Prospective Studies
Respiration, Artificial
Sepsis - diagnostic imaging
Sepsis - mortality
Sepsis - physiopathology
Sepsis - therapy
Shock, Septic - diagnostic imaging
Shock, Septic - mortality
Shock, Septic - physiopathology
Shock, Septic - therapy
Treatment Outcome
Ventricular Dysfunction, Left - etiology
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Summary:Background: Left ventricular systolic dysfunction (LVSD) and LV diastolic dysfunction (LVDD) are commonly seen in severe sepsis and septic shock; however, their role in patients with concurrent invasive mechanical ventilation (IMV) is less well defined. Methods: This was a prospective observational study on all patients admitted to all the intensive care units (ICUs) at Mayo Clinic, Rochester from August 2007 to January 2009. All adult patients with severe sepsis and septic shock and concurrent IMV without prior heart failure underwent transthoracic echocardiography within 24 hours. Patients with active pregnancy, prior congenital or valvular heart disease, and prosthetic cardiac valves were excluded. Left ventricular systolic dysfunction was defined as LV ejection fraction (LVEF) 15. Primary outcome was hospital mortality, and secondary outcomes included IMV duration, ICU length of stay (LOS), and total LOS. Two-tailed P value of
ISSN:0885-0666
1525-1489
DOI:10.1177/0885066616684774