Heart & lung : the journal of critical care · 2026
Early transthoracic echocardiography improves in-hospital mortality and fluid resuscitation in septic ICU patients with impaired cardiac function.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ma Zhiyuan, Elmi Cyrus P, Krishnamurthy Mahesh, Allen David, Puleo Peter, Shirani Jamshid
Аннотация
BACKGROUND: Transthoracic echocardiography (TTE) is increasingly utilized in the intensive care unit (ICU), yet the optimal timing of TTE in sepsis remains unclear.
OBJECTIVE: To examine the impact of early versus late TTE on mortality and fluid resuscitation, stratified by left ventricular ejection fraction (LVEF).
METHODS: We conducted a retrospective cohort study using the MIMIC-III database. Septic ICU patients who underwent TTE were included. Unmatched and overlap-weighted matched analyses were performed. Multivariable logistic regression assessed in-hospital mortality, and Cox regression evaluated 1-year mortality. LVEF was categorized as severe (<30%), moderate (30-39%), mild (40-49%), or normal (≥50%).
RESULTS: Of 10,232 patients, 3145 (30.7%) and 4116 (40.2%) received early TTE within 6 and 12 h, respectively. In-hospital mortality was lower in patients with TTE within 6 h (12.1% vs. 17.2%, P < 0.001). Early TTE was associated with reduced in-hospital mortality (adjusted odds ratio [OR] 0.77, 95% CI 0.67-0.88, P < 0.001; overlap-weighted OR 0.78, 95% CI 0.68-0.89, P < 0.003). No association was observed with 1-year mortality. Early TTE was linked to greater 24-hour fluid administration in patients with impaired LVEF: mild (median 3109 mL vs. 2107 mL, P < 0.001), moderate (2587 mL vs. 1840 mL, P < 0.001), and severe (2193 mL vs. 1839 mL, P = 0.002), but not in those with normal LVEF. Similar findings were observed when TTEs were performed within 12 h.
CONCLUSIONS: Early TTE in sepsis is associated with greater fluid resuscitation in those with impaired LVEF and with reduced in-hospital mortality.
OBJECTIVE: To examine the impact of early versus late TTE on mortality and fluid resuscitation, stratified by left ventricular ejection fraction (LVEF).
METHODS: We conducted a retrospective cohort study using the MIMIC-III database. Septic ICU patients who underwent TTE were included. Unmatched and overlap-weighted matched analyses were performed. Multivariable logistic regression assessed in-hospital mortality, and Cox regression evaluated 1-year mortality. LVEF was categorized as severe (<30%), moderate (30-39%), mild (40-49%), or normal (≥50%).
RESULTS: Of 10,232 patients, 3145 (30.7%) and 4116 (40.2%) received early TTE within 6 and 12 h, respectively. In-hospital mortality was lower in patients with TTE within 6 h (12.1% vs. 17.2%, P < 0.001). Early TTE was associated with reduced in-hospital mortality (adjusted odds ratio [OR] 0.77, 95% CI 0.67-0.88, P < 0.001; overlap-weighted OR 0.78, 95% CI 0.68-0.89, P < 0.003). No association was observed with 1-year mortality. Early TTE was linked to greater 24-hour fluid administration in patients with impaired LVEF: mild (median 3109 mL vs. 2107 mL, P < 0.001), moderate (2587 mL vs. 1840 mL, P < 0.001), and severe (2193 mL vs. 1839 mL, P = 0.002), but not in those with normal LVEF. Similar findings were observed when TTEs were performed within 12 h.
CONCLUSIONS: Early TTE in sepsis is associated with greater fluid resuscitation in those with impaired LVEF and with reduced in-hospital mortality.