- In patients with sepsis and septic shock, this study found that right ventricular (RV) dysfunction was associated with higher 28-day mortality.
- Prospective studies are needed.
Why this matters
- RV dysfunction in this population is not well understood.
- Severe septic cardiomyopathy can precede or accompany multiorgan failure.
- 93 patients died.
- RV dysfunction: 48%.
- Left ventricular (LV) dysfunction: 74%.
- Isolated RV dysfunction: 9%.
- On multivariate analysis, mortality risk (ORs; 95% CIs), with:
- RV dysfunction: 3.37 (1.67-6.78).
- LV systolic dysfunction: 0.63 (0.32-1.24).
- LV diastolic dysfunction: 1.26 (0.64-2.50).
- Single-center, retrospective, observational study; secondary analysis of prospectively collected data (n=393).
- Adults with severe sepsis or septic shock underwent transthoracic echocardiography for clinical indications within 24 hours of ICU admission.
- RV dysfunction defined as either:
- RV fractional area change
- Tricuspid annulus systolic plane excursion
- Outcome: 28-day mortality.
- Funding: Easton Family Fund; Intermountain Research and Medical Foundation.
- Studies performed by registered diagnostic cardiac sonographers.
- Potential selection bias, as more stable patients may not have received echocardiography.
- Unknown if cardiac dysfunction preceded sepsis.
- Dysfunction definitions may have misclassified patients with borderline values.