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温度轨迹与败血症患者的心脏功能相关
Annabel H Lu1, Vardhmaan Jain2, Po-Han Chen3
1Emory University School of Medicine, Atlanta, GA.
Critical care explorations
|July 9, 2025
概括
败血症患者的体温模式显著影响心脏功能. 低温性败血症患者表现出左和右心室功能障碍的最高风险,强调了早期监测的必要性.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 感染患者的体温模式反映了动态的临床和免疫反应.
- 了解这些温度轨迹对于预测患者的结果至关重要.
研究的目的:
- 调查不同体温轨迹亚表型与心脏功能障碍之间的关联.
- 为了确定温度模式是否可以预测心声学证据的心脏功能障碍在败血症.
主要方法:
- 一项回顾性队列研究在一个学术医疗保健系统内的四家医院进行.
- 包括怀疑感染的成年患者,在入院后48小时内接受心声扫描.
- 患者被分为四个温度轨迹亚表型,使用一个验证的模型.
主要成果:
- 在1923名败血症患者中,确定了四种亚现象:高热 (缓慢/快速解决者),正常热和低温.
- 低温患者表现出左心室功能障碍 (46%) 和右心室功能障碍 (39%) 的最高率.
- 多变量分析显示,低温患者的几率比率 (2.65) 显著更高,左心室喷射率降低,血管压缩剂/异位物使用增加,住院死亡率更高.
结论:
- 败血症中的温度轨迹与心脏功能障碍有显著联系,特别是在低温患者中.
- 败血症的低温与左室和右室功能障碍的最高几率有关.
- 床边温度监测可以作为败血症回声心脏学评估的早期指标,需要进一步验证.
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