[Myocardial dysfunction and its prognostic utility in sepsis and septic shock].

BACKGROUND

Sepsis is a potentially mortal infection which is related to multiple organ dysfunction; it has a high morbidity and mortality. Myocardial dysfunction is frequent in sepsis and it is related to unfavorable outcomes.

Objective

To describe by transthoracic echocardiography the clinical distribution of myocardial dysfunction in sepsis and septic shock and estimate its prognostic utility.

MATERIAL AND

METHODS

Cross-sectional study based on a multi-centric prospective cohort study in 4 reference centers in Bucaramanga, Colombia, and its metropolitan area. 271 patients with sepsis and septic shock were included; they underwent standard transthoracic echocardiography and a 30-day follow-up.

RESULTS

There was no difference in the left ventricular ejection fraction (p = 0.061) between survivors and non-survivors. 51 patients (48.71%) had grade I diastolic dysfunction, 48 patients (14.52%) had grade II dysfunction and 21 patients (36.75%) had grade III diastolic dysfunction. Mortality was higher in patients with grade I diastolic dysfunction when compared to those with grade II dysfunction (p = 0.023).

CONCLUSIONS

The higher mortality in grade I diastolic dysfunction suggests that patients with low filling pressures have worst outcomes. On the other hand, left ventricular ejection fraction per se is not associated with a higher mortality in sepsis.