Blancas MLF, Martínez CRR, Sánchez DJS, Peniche MKG, Ramírez SP, Calyeca SMV

Language: Spanish
References: 26
Page: 245-250
PDF size: 284.98 Kb.

ABSTRACT

Introduction: acute metabolic acidemia is a frequent alteration in critically ill patients, with cardiovascular repercussions including myocardial depression, hypotension, reduced vasopressor effectiveness, and arrhythmias. Its impact in humans, assessed by non-invasive methods such as basic echocardiography, remains limited. Objective: to evaluate the relationship between acute metabolic acidemia and echocardiographic variables of cardiac function in patients with septic shock admitted to the intensive care unit (ICU). Material and methods: prospective, observational, cross-sectional cohort study conducted at Hospital de Especialidades No. 14, IMSS, Veracruz, between January and December 2024. Adult patients with septic shock and metabolic acidemia (pH < 7.35, BEecf). Results: thirty patients were included, 17 with pH < 7.20 and 13 with pH ≥ 7.20. Overall mortality was 50%, with no significant difference between groups. Patients with pH < 7.20 required higher doses of norepinephrine (0.50 vs 0.35 μg/kg/min, p = 0.013) and vasopressin (0.6 vs 0.5 UI/min, p = 0.038). Lower cardiac index [CI] (2.1 vs 3.0 L/min/m², p = 0.042) and left ventricular ejection fraction [LVEF] (59 vs 69%, p = 0.005) were observed in the pH < 7.20 group. pH showed a moderate positive correlation with CI (r = 0.584, p = 0.001) and LVEF (r = 0.577, p = 0.001). Conclusion: in patients with septic shock, severe acute metabolic acidemia (pH < 7.20) is associated with deterioration of cardiac function and increased vasopressor requirements, with a moderate correlation between pH and systolic function variables, although without a significant impact on mortality.

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