EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSIS

The objective of the study: to find early hemodynamic predictors of a lethal outcome of abdominal sepsis.Methods. 44 patients with abdominal sepsis with no signs of septic shock were enrolled into a retrospective study. The age of patients made 48.7 Ѓ} 2.26 years old; the severity of state according...

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Main Authors: I. A. Kozlov, I. N. Tyurin, S. А. Rаutbаrt
Format: Article
Language:Russian
Published: New Terra Publishing House 2018-05-01
Series:Вестник анестезиологии и реаниматологии
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Online Access:https://www.vair-journal.com/jour/article/view/224
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author I. A. Kozlov
I. N. Tyurin
S. А. Rаutbаrt
author_facet I. A. Kozlov
I. N. Tyurin
S. А. Rаutbаrt
author_sort I. A. Kozlov
collection DOAJ
description The objective of the study: to find early hemodynamic predictors of a lethal outcome of abdominal sepsis.Methods. 44 patients with abdominal sepsis with no signs of septic shock were enrolled into a retrospective study. The age of patients made 48.7 Ѓ} 2.26 years old; the severity of state according to APACHE II was 12.50 Ѓ} 0.55 scores, and as per SOFA ‒ 8 [6; 10]) scores. Hemodynamics was assessed through transpulmonary thermodilution.Results. During the first 24 hours, the following rates were the most sensitive and specific in respect of a lethal outcome: cardiac function index (odds ratio – 0.582; 95%CI 0.388-0.872; p = 0.008), and cardiac power index (odds ratio – 0.027; 95%CI 0.001-0.6; p = 0.022). The same results were observed in 4-5 days of treatment. At different stages of the study, the following rates demonstrated stable predictive significance: cardiac index (CI), systolic output index, global ejection fraction; and the area under ROC-curves (AUROC) for these rates was compatible with AUROC as per SOFA.Conclusion: The investigation of the after-load dependent relative cardiac efficiency proved that the normal values of CI could be predictive of an unfavorable sepsis outcome if after-load dependent relative cardiac efficiency was < 80%. It is sensible to define individual target values of cardiac hemodynamics, which significance is clinically proved in case of sepsis.
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spelling doaj-art-8ef1a8de0e82482ea0fa5aa758042abb2025-08-20T03:56:33ZrusNew Terra Publishing HouseВестник анестезиологии и реаниматологии2078-56582541-86532018-05-0115261510.21292/2078-5658-2018-15-2-6-15221EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSISI. A. Kozlov0I. N. Tyurin1S. А. Rаutbаrt2M. F. Vladimirsky Moscow Regional Research Clinical Institute; Moscow City Clinical Hospital after V. M. BuyanovMoscow City Clinical Hospital after V. M. Buyanov; Pirogov Russian National Research Medical UniversityMoscow City Clinical Hospital after V. M. BuyanovThe objective of the study: to find early hemodynamic predictors of a lethal outcome of abdominal sepsis.Methods. 44 patients with abdominal sepsis with no signs of septic shock were enrolled into a retrospective study. The age of patients made 48.7 Ѓ} 2.26 years old; the severity of state according to APACHE II was 12.50 Ѓ} 0.55 scores, and as per SOFA ‒ 8 [6; 10]) scores. Hemodynamics was assessed through transpulmonary thermodilution.Results. During the first 24 hours, the following rates were the most sensitive and specific in respect of a lethal outcome: cardiac function index (odds ratio – 0.582; 95%CI 0.388-0.872; p = 0.008), and cardiac power index (odds ratio – 0.027; 95%CI 0.001-0.6; p = 0.022). The same results were observed in 4-5 days of treatment. At different stages of the study, the following rates demonstrated stable predictive significance: cardiac index (CI), systolic output index, global ejection fraction; and the area under ROC-curves (AUROC) for these rates was compatible with AUROC as per SOFA.Conclusion: The investigation of the after-load dependent relative cardiac efficiency proved that the normal values of CI could be predictive of an unfavorable sepsis outcome if after-load dependent relative cardiac efficiency was < 80%. It is sensible to define individual target values of cardiac hemodynamics, which significance is clinically proved in case of sepsis.https://www.vair-journal.com/jour/article/view/224sepsisseptic cardiomyopathycentral hemodynamicscardiac function indexdiastolic dysfunction in sepsistranspulmonary thermodilution
spellingShingle I. A. Kozlov
I. N. Tyurin
S. А. Rаutbаrt
EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSIS
Вестник анестезиологии и реаниматологии
sepsis
septic cardiomyopathy
central hemodynamics
cardiac function index
diastolic dysfunction in sepsis
transpulmonary thermodilution
title EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSIS
title_full EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSIS
title_fullStr EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSIS
title_full_unstemmed EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSIS
title_short EARLY HEMODYNAMIC PREDICTORS OF LETHAL OUTCOMES OF ABDOMINAL SEPSIS
title_sort early hemodynamic predictors of lethal outcomes of abdominal sepsis
topic sepsis
septic cardiomyopathy
central hemodynamics
cardiac function index
diastolic dysfunction in sepsis
transpulmonary thermodilution
url https://www.vair-journal.com/jour/article/view/224
work_keys_str_mv AT iakozlov earlyhemodynamicpredictorsoflethaloutcomesofabdominalsepsis
AT intyurin earlyhemodynamicpredictorsoflethaloutcomesofabdominalsepsis
AT sarautbart earlyhemodynamicpredictorsoflethaloutcomesofabdominalsepsis