Assessment of left and right ventricular Tei indices in critically ill children with septic shock

Abstract

BackgroundChildren with septic shock are subjected to global myocardial dysfunction. Myocardial performance (Tei) index has been used to detect the combined systolic and diastolic ventricular function in adult and neonatal sepsis. ObjectivesAssessment of left and right ventricular Tei indices in critically ill children with septic shock treated with inotropes and/or vasoactive agents. MethodsNinety children with septic shock and 90 controls were examined by conventional echocardiography. Cardiac chamber dimensions, ejection fraction, cardiac index, left and right ventricular Tei indices were measured. Severity of sepsis was detected using Pediatric index of mortality 2 score. ResultsPatients had significantly lower mean values of left ventricular internal diameter in diastole and left atrial diameter when compared to controls (p < 0.05). Patients and non-survivors had significantly higher mean values of left and right ventricular Tei indices when compared to controls and survivors respectively (p < 0.05). Mean values of ejection fraction and cardiac index were significantly lower in patients when compared to their controls (p < 0.001). Pediatric index of mortality 2 score correlated positively with the left ventricular Tei index (r = 0.334, p < 0.001), right ventricular Tei index (r = 0.544, p < 0.001) and negatively with the left ventricular internal diameter in diastole (r = − 0.224, p < 0.03). ConclusionPediatric sepsis is associated with global myocardial dysfunction. Tei index is a rapid simple parameter that can be used for the evaluation of myocardial dysfunction in children with septic shock. Pediatric index of mortality 2 score correlated positively with Tei indices, hence we recommend they could be used for grading of sepsis severity in the future.