A study of echocardioghraphic indices in patients of sepsis and severe sepsis
Journal Title: INTERNATIONAL JOURNAL OF RECENT TRENDS IN SCIENCE AND TECHNOLOGY - Year 2016, Vol 20, Issue 3
Abstract
Introduction: Patients with sepsis have a markedly depressed LV ejection fraction, a low cardiac output as measured by the Doppler technique, and systemic vascular resistance higher than usual in sepsis. Aims and Objectives: To evaluate the various echocardiographic indices in patients of sepsis, severe sepsis and septic shock. To correlate these various clinical parameters and echocardiographic indices with the outcome. Material and Methods: This hospital based prospective analytic observational study was performed in the parent institute from June 2009 to November 2010. A total of 70 cases of sepsis who were admitted in Medical ward or in the medical ICU were studied. INCLUSION CRITERIA: All patients satisfying the criteria for sepsis admitted to ICU and Medicine Wards. Observation and Results: This was a hospital based observational study which was done with 70 patients of sepsis who were admitted in Medicine wards or in the Medical ICU of the parent Institute. Out of 70 cases studied 50 were males as compared to 31 females..Majority of cases were between age group of 41- 50 years. Mean age of the cases was 43.2± 15.3 years. The most common symptom was fever which was present in 85% of the patients,. Of the 70 subjects included in the study, 26(37.1%) had presented with sepsis, 32(45.7%) had severe sepsis and 12 (17.2%) patients were in septic shock. 46 (66%) survived and 24 (34%) succumbed to the illness. The most common etiology in severe sepsis was consolidation and was present in 47% of the patients.. In septic shock, the most common etiology and clinical presentation was consolidation (58%). In the non survivors, admission EF ≥40 were found in 21 patients (87%) and, EF ≤40 were found in 3 patients (13%). In the survivors, EF ≥40 were found in 29 patients (63%) and, EF ≤40 were found in 17 patients (37%). Thus in our study 17 patients died with Distributive Shock (71%) and 7 patients (29%) died with Cardiogenic Shock had myocardial depression. Conclusion: The mortality was more in the septic shock patients (83%) as compared to those with severe sepsis (43.7%).Ejection Fraction and Cardiac Output was higher in Non survivors than Survivors at time of admission. However in non survivors, there were progressive decline. in ejection fraction over a period of stay but still their cardiac output was in normal range.
Authors and Affiliations
Prashant Gajbhiye, Chandrashekhar S Dhurve
Keywords
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