Abstract
BackgroundThe 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.MethodsSeptic 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.ResultsEighty-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.ConclusionsRight heart dimensional and functional abnormalities exist in high proportions in septic shock. However, their predictability of poor outcomes remains questionable.
Highlights
The right heart often receives less attention during echocardiography
Septic shock was defined as sepsis with hypotension despite initial volume resuscitation in accordance with the American College of Chest physicians (ACCP)/Society of Critical Care Medicine (SCCM) Consensus Conference Committee [11]
Five hundred adult patients were admitted to our intensive care unit (ICU) during the study period of 2 years
Summary
The right heart often receives less attention during echocardiography. The situation is no different in septic shock. Ill-defined endocardial surface, and retrosternal right ventricle (RV) impose challenges to imaging of the right heart (RH) [1] This has often resulted in RH receiving less attention during echocardiography. Unfamiliarity with optimal ultrasound imaging techniques and absence of RH data indexed to gender, height, and weight have only widened the gap. Both transesophageal echocardiography (TEE) [2,3,4,5] and transthoracic echocardiography (TTE) [6,7,8,9,10] have been used to study the dimensional and functional aspects of RH. Sepsis is a clinical syndrome caused by severe infection and is characterized by a systemic inflammation
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