Key result
Right heart dimensional and functional abnormalities were highly prevalent in septic shock patients (79%, 25%, and 86% for chamber dimension, systolic, and diastolic function, respectively) but did not significantly predict mortality.
Why the study?
Do right heart dimensional and functional abnormalities on transthoracic echocardiography predict mortality in adult patients with septic shock?
Observational (n=88)
No
Do right heart dimensional and functional abnormalities on transthoracic echocardiography predict mortality in adult patients with septic shock?
Prevalent right heart abnormalities in septic shock lack prognostic value; leaves open any role in management or monitoring.
BACKGROUND: The right heart often receives less attention during echocardiography. The situation is no different in septic shock. We prospectively investigated the echocardiographic indices of the right heart in septic shock adult patients. METHODS: Septic shock ICU patients within 24 h of admission were subjected to transthoracic echocardiography (TTE) as per the 2005 guidelines from the American Society of Echocardiography. RESULTS: Eighty-eight septic shock patients (M:F = 52:36) underwent TTE. Thirty-six patients survived. Significant differences in demographic and biochemical (laboratory and metabolic) parameters, severity scores, life-support therapies (vasopressors, ventilation), and length of ICU stay were observed between survivors and non-survivors. Right heart abnormalities of chamber dimension and systolic and diastolic function existed in 79, 25, and 86 % of patients, respectively. Right ventricle subcostal wall thickness (91 %), pulse Doppler myocardial performance index (73 %), and E/E' (63 %) were the predominant abnormalities in chamber dimension, systolic function, and diastolic function of the right heart, respectively. However, the presence of these abnormalities did not signify poor survival in our study. CONCLUSIONS: Right heart dimensional and functional abnormalities exist in high proportions in septic shock. However, their predictability of poor outcomes remains questionable.
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Singh et al. (2016) conducted an observational in Septic shock (n=88). Transthoracic echocardiography (TTE) vs. Survivors vs Non-survivors was evaluated on Right heart dimensional and functional abnormalities and their association with survival. Right heart dimensional and functional abnormalities were highly prevalent in septic shock patients (79%, 25%, and 86% for chamber dimension, systolic, and diastolic function, respectively) but did not significantly predict mortality.
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