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A Prospective Observational Study to Determine Incidence and Outcome of Sepsis-induced Cardiomyopathy in an Intensive
Sonali Bansal1, Siddarth Varshney2, Anupam Shrivastava3
1Department of Critical Care, SPS Hospital, Ludhiana, Punjab, India.
Insights
Sepsis-induced cardiomyopathy (SICM) affects 14% of ICU patients, leading to longer hospital stays and increased mortality. Early echocardiography diagnosis is crucial for managing this condition and improving patient outcomes.
Area of Science:
- Cardiology
- Critical Care Medicine
- Infectious Diseases
Background:
- Sepsis frequently causes myocardial dysfunction, impacting patient prognosis.
- Echocardiography (ECHO) aids in diagnosing cardiac dysfunction for timely intervention.
- Limited Indian data exists on septic cardiomyopathy incidence and ICU outcomes.
Purpose of the Study:
- To determine the incidence of sepsis-induced cardiomyopathy (SICM) in North Indian ICU patients.
- To analyze the influence of SICM on intensive care unit (ICU) outcomes, including mortality and length of stay.
- To correlate left ventricular (LV) dysfunction with clinical outcomes in sepsis patients.
Main Methods:
- A prospective observational study involving consecutive sepsis patients admitted to a tertiary care ICU in North India.
- Echocardiography (ECHO) performed 48-72 hours post-admission to assess left ventricular (LV) dysfunction.
- Analysis of ICU outcomes, including mechanical ventilation duration, mortality, and length of stay, comparing patients with and without LV dysfunction.
Main Results:
- Left ventricular (LV) dysfunction was observed in 14% of sepsis patients.
- Systolic dysfunction occurred in 42.86%, diastolic in 7.14%, and combined in 50% of patients with LV dysfunction.
- Patients with LV dysfunction had longer mechanical ventilation (4.43 vs. 2.41 days) and ICU stays (13.21 vs. 8.26 days), though mortality difference was not significant (p=0.409).
Conclusions:
- Sepsis-induced cardiomyopathy (SICM) is prevalent and clinically significant in the ICU setting.
- Patients with SICM experience prolonged ICU stays and mechanical ventilation.
- Early identification of SICM via echocardiography is vital for managing sepsis patients.
Introduction:
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).
Materials And Methods:
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.
Result:
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) (p = 0.034). Incidence of all-cause ICU mortality was 11 (12.79%) in group I and 3 (21.43%) in group II (p = 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.
Conclusion:
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.
How To Cite This Article:
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.
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