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Right heart in septic shock: prospective observational study.

Ratender Kumar Singh1, Sudeep Kumar2, Sreevatsa Nadig2

  • 1Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh 226014 India.

Journal of Intensive Care
|June 10, 2016
PubMed
Summary

Right heart abnormalities are common in septic shock patients, affecting chamber dimensions and function. However, these echocardiographic findings do not reliably predict patient survival.

Keywords:
Right heartSeptic shockTransthoracic echocardiography

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Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Echocardiography

Background:

  • The right heart is often under-evaluated in echocardiography, including in cases of septic shock.
  • This study focuses on assessing right heart echocardiographic indices in adult patients with septic shock.

Purpose of the Study:

  • To prospectively investigate echocardiographic indices of the right heart in adult patients experiencing septic shock.
  • To determine the prevalence of right heart abnormalities in septic shock and their correlation with patient outcomes.

Main Methods:

  • Transthoracic echocardiography (TTE) was performed on 88 septic shock ICU patients within 24 hours of admission.
  • Echocardiographic parameters assessed included chamber dimensions, systolic function, and diastolic function of the right heart, following 2005 American Society of Echocardiography guidelines.

Main Results:

  • Right heart abnormalities were prevalent, with 79% showing dimension abnormalities, 25% systolic dysfunction, and 86% diastolic dysfunction.
  • Predominant abnormalities included right ventricle subcostal wall thickness (91%), pulse Doppler myocardial performance index (73%), and E/E' (63%).
  • Despite high prevalence, these right heart abnormalities did not significantly predict poor survival in the study cohort.

Conclusions:

  • High proportions of dimensional and functional right heart abnormalities are present in septic shock patients.
  • The predictive value of these echocardiographic abnormalities for poor outcomes in septic shock remains uncertain.