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在败血症患者中,左心室高动态缩功能的患病率和预后:系统性审查和元分析

Ryota Sato¹, Filippo Sanfilippo², Daisuke Hasegawa³

¹Division of Critical Care Medicine, Department of Medicine, The Queen's Medical Center, Honolulu, HI, USA.

Annals of intensive care

|February 3, 2024

概括

超动态左心室 (LV) 缩功能影响了18.2%的败血症患者,并与2.37倍的短期死亡风险增加有关. 这种状况的特点是高LV喷射率 (LVEF),在败血症管理中需要进一步的临床关注.

科学领域:

心脏病学心脏病学
关键护理医学关键护理医学
内部医学内部医学

背景情况:

败血症是一种危及生命的器官功能障碍,其原因是宿主对感染的反应失调.
左心室 (LV) 缩功能在败血症中的特征,特别是高动态的LV缩功能,以及它们的预后影响尚未完全理解.
超动态的 LV 缩功能,定义为高的 LV 喷射分数 (LVEF),在败血症患者中不一致报告.

研究的目的:

系统地审查和元分析患有败血症的成年患者中高动态LV缩功能的患病率.
调查高动态LV缩功能与败血症患者的短期死亡率之间的关联.
探索二次结果,包括心率,LV终端-透气直径 (LVEDD) 和E/e'比.

主要方法:

在MEDLINE,科克伦控制试验中央注册表和Embase的系统文献搜索.
包括四项研究进行元分析.
使用70%的LVEF截止值来定义高动态LV缩功能的定义.

主要成果:

在败血症患者中,高动态 LV 系统功能的综合患病率为 18.2% (95% CI 12.5,25.8).
超动态 LV 缩功能与较高的短期死亡率显著相关 (OR 2.37;95% CI 1.47,3.80).
患有高动态LV缩功能的患者表现出更高的心率和LVEDD,但与正常LV功能患者相比,E/e'比率没有显著差异.

结论:

超动态 LV 缩功能是相当大比例的败血症患者的显著发现.
这种情况独立地与败血症短期死亡风险的大幅增加有关.
这些发现突显了评估LV缩功能在败血症中对于风险分层和管理的重要性.

关键词:

超动态超动态超动态这是一种超运动的超运动.左心室喷射分数的部分.死亡率死亡率死亡率败血症这是一种败血症.败血症的冲击是一个令人震惊的结果.

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