败血症引起的心肌功能障碍,诊断为应变与非应变心声学参数:发病率,演变和与预后的关联
Filipe André Gonzalez1,2,3, Jacobo Bacariza4, Ana Rita Varudo4
1Faculdade de Medicina, Centro Cardiovascular da Universidade de Lisboa, CCUL@RISE, Universidade de Lisboa, Av. Prof. Egas Moniz MB, Lisboa, 1649-028, Portugal. filipeandregonzalez@edu.ulisboa.pt.
Annals of intensive care
|September 25, 2025
概括
斑点跟踪心声学 (STE) 在败血症休克患者中发现了更多的败血症诱导的心肌功能障碍 (SIMD) 病例. 然而,与标准标准相比,这种先进的方法并不能提高预后价值.
科学领域:
- 心脏病学 心脏病学
- 关键护理医学 关键护理医学
- 心声回声扫描 (Echocardiography) 是一种心声回声扫描.
背景情况:
- 败血症诱导的心肌功能障碍 (SIMD) 由于使用高级心声回声学进行的纵向研究有限,因此对其了解甚少.
- 斑点跟踪回声心脏学 (STE) 提供了先进的成像,用于表征SIMD进展.
研究的目的:
- 使用斑点跟踪心声学 (STE) 描述败血症诱导的心肌功能障碍 (SIMD) 的进展.
- 将STE的诊断和预后价值与SIMD的非STE标准进行比较.
主要方法:
- 对98名在重症监护中的败血性休克患者进行的前性单中心研究.
- 在第1,7和30天使用STE或非STE标准来确定左心室 (LV) 和右心室 (RV) 功能障碍的SIMD.
- 考克斯回归分析用于评估SIMD标准30天死亡率的预后价值.
主要成果:
- 在第一天,SIMD患病率高于STE (71.4%),而不是非STE (58.2%),尽管在统计学上并不显著.
- 在STE和非STE之间,在LV静脉透析功能障碍诊断中没有显著差异.
- 30天死亡率与非STE标准 (p=0.010) 诊断的SIMD相关,但不是STE (p=0.057).
- 只有通过非STE标准的LV透气功能障碍预测了30天死亡率 (p=0.005).
结论:
- 在使用STE标准时,感染性休克中SIMD的发生率更高.
- 通过STE识别的SIMD在第一个星期显示出较低的可逆性.
- 使用STE标准对SIMD的广泛定义似乎没有比标准标准提供额外的预后价值.
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