Torres-Rojo YI, Gutiérrez-Bernal JL, Castillejos-Zenteno CF, Macías-León C, Viveros-Rentería E

Language: Spanish
References: 17
Page: 60-64
PDF size: 86.51 Kb.

ABSTRACT

Introduction: Sepsis is a clinical syndrome characterized by a systemic response to infection. Both severe sepsis and septic shock may be complicated by multiple organ failure. Reversible myocardial dysfunction may occur in up to 40% of patients with sepsis. Diastolic myocardial function in sepsis has been seldom investigated. Tei index is a non-invasive Doppler-derived myocardial performance method of evaluation that assesses simultaneously systolic and diastolic left ventricular performance. Objective: To evaluate left ventricular global performance in patients with severe sepsis or septic shock with the Tei index. Methods: Observational, transversal study. A transthoracic echocardiogram was carried out within 24 hours of diagnosis of severe sepsis/septic shock. Left ventricular ejection fraction (LVEF) was measured and segmental wall contractility was assessed; transmitral and left ventricle outflow tract flow spectrum were recorded to obtain the Tei index. Results: From May to December 2004, 268 patients were hospitalized in the Intensive Care Unit at the Hospital Español de Mexico. Diagnosis of severe sepsis or septic shock was made in 27 patients, of whom 9 fulfilled inclusion criteria (4 patients with severe sepsis and 5 with septic shock); mean age was 46.7 ± 13.5 and 8 patients were men. Mean LVEF was 60.5 ± 7.5% in the severe sepsis group and 49.0 ± 8.0% in the septic shock group (p ‹ 0.05). Mean Tei index was 0.246 ± 0.101 in the severe sepsis group and 0.419 ± 0.144 in the septic shock group (p ‹ 0.05). Segmental left ventricular wall motion abnormalities in 2 patients in the septic shock group. Conclusions: Despite the small sample size in the present study, our results suggest that Tei index is useful to assess left ventricular global dysfunction in patients with sepsis and that it correlates with sepsis severity.

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