The dynamic changes of cardiac function and its associated with prognosis in patients with septic shock

Objective To investigate the dynamic change of cardiac function in the patients of septic shock and analyze its influence to prognosis. Methods A total of 129 patients were enrolled in the investigation using mornitoring the hemodynamics including the contour pulse wave mean artery pressure (MAP), cardiac index (CI) and systemic vascular resistance indes (SVRI). Echocardiography was done 7 days laterenrollment of left ventricular eject fraction (LVEF), E and A peak of mitral blood flow velocity, mitral annulus moving speed (E’) were detected changes. E/A and E/E’ were calculated. According to the 28-day prognosis, all patients were devided into the survival and death group for detecting the risk factors of death. Results In all patients, hemodynamics detected changes showed the features of septic shock with high output and low vascular risistance. The values of CI in the survival group and death group were (4.30±0.71) L/min/m2 and (4.52±0.91) L/ (min·m2) , repectively,and the values of SVRI were (1 477±297) dyn·s·cm-5·m2 and (1 488±233) dyn·s·cm-5·m2, repectively. There were no significant differences in CI and SVRI were found between the two groups (both P>0.05). When 7 days after admission in hospital, CI [(3.88±0.51) L/ (min·m2) ] was lower and SVRI [(2 044±266) dyn·s·cm-5·m2] was higher compared with those at admission in the survival group with significant differences, between the two intervals (all P 0.05). Compared with survival group, LVEF significantly decreased (64.4%±16.3)% vs. (54.4±17.6)% and E/E’ (8.73±0.67) vs. (9.97±0.55) , all P<0.01] was significantly decreased in the death group. APACHE II (OR=1.667, 95%CI: 1.322-1.863, P=0.001), LVEF (OR=0.809, 95%CI: 0.612-0.912, P=0.001) and E/E’ (OR=1.219, 95%CI: 1.030-1.501, P=0.006) were detected to be the risk factors by logistic analysis. Conclusions In septic shock patients, both the systolic, and the diastolic cardiac function were found to be significantly abnormal , resulting poor prognosis. Key words: Septic shock; Cardiac function; Hemodynamic; Pulse wavecontour; Echocardiography