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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Aim The aim was to assess right ventricle function in septic shock patients using transthoracic echocardiography after resuscitation at the emergency department. Background Because septic cardiomyopathy has no formal definition due to complexity of the cardiovascular system, variable methods of assessment, and variations in the preseptic state of the heart, early assessment of right ventricle function may reduce mortality of septic shock patients. Introduction Cardiac contractility is impaired during early phases of septic shock and early invasive assessment methods were of limited utility to emergency physicians, so using of echocardiography in the emergency department is available, noninvasive, and easily repeatable method for evaluation of septic cardiomyopathy. Patients and methods This is a prospective observational study done on 60 septic shock patients, who presented to the Emergency Department of Menoufia University Hospital during the period from January 2020 to December 2020. Results Patients were categorized into three groups according to right ventricle fractional change (RVFAC%) and left ventricle ejection fraction (LVEF%). Group I (28) patients have normal RV function, Group II (17) patients have isolated RV dysfunction, and Group III (15) patients have combined RV and LV systolic dysfunction. There were statistically significant differences between studied groups in their mean arterial pressure readings (P = 0.001) and mean arterial pressure was higher in group I than group III (P2 = 0.001). Also, there was a statistically significant difference between groups in their HCO3 (P = 0.014) and it was significantly higher in group I than group III (P2 = 0.023). And statistically significant differences between the three studied groups in their tricuspid annular plane systolic excursion (P = 0.011). Tricuspid annular plane systolic excursion was higher in group I more than group III (P2 = 0.019) and higher in group II more than group III (P3 = 0.026). Conclusion Myocardial dysfunction is frequent in patients with severe sepsis and septic shock and presents in a wide spectrum, including left ventricle and/or right ventricle dysfunction.

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