Cardiovascular Parameters Associated With Troponin I as Indicators for 14-Day Mortality in Patients With Septic Shock

Su, Wen‐Lin; Shui, Hao‐Ai; Cui, Lan; Yang, Mei‐Chen; Hsieh, Chien-An; Jang, Sung-Won; Chung, Hsueh-Wen; Wu, Yao‐Kuang

doi:10.1016/j.amjms.2018.05.008

Cited by 8 publications

(4 citation statements)

References 35 publications

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“…CI has been proposed as helpful tools to detect impaired cardiac function in sepsis. Nevertheless, studies found that patients with septic shock often had a normal or elevated CI due to the decrease in SVR (9,18). In recent years, more sophisticated techniques such as STT was proved to be an accurate marker of intrinsic cardiac function.…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis, there were no signi cant differences in LVEF, right ventricular ejection fractions, and right ventricular dimensions between the survivor and non-survivor groups (8). Su et al demonstrated that only low CI combined with high stroke volume variation increased mortality (9). Accordingly, LVEF and CI are not ideal indicators for SCM.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Accuracy of the Afterload-related Cardiac Performance for 7-day Mortality Among Critical Ill Patients With Septic Shock

Chen

Tao

et al. 2020

Preprint

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BackgroundSeptic patients with cardiac impairment are with high mortality. Afterload-related cardiac performance (ACP), as a new tool for diagnostic septic cardiomyopathy (SCM), still needs to be evaluated its impact on the prognosis for patients with septic shock. MethodsIn this observational retrospective study, 119 patients with septic shock undertaken PiCCO monitoring were evaluated for the effects of ACP on 7-day mortality, ICU mortality and hospital mortality. The ability of ACP, cardiac index (CI) and left ventricular ejection fraction (LVEF) to discriminate between survivors and non-survivors was tested by comparing the area under the receiver operating characteristic curve (AUROC) analysis. Multivariable logistic regression and Cox proportional hazards regression analyses were performed to assess the associations of ACP with 7-day mortality. Curve estimation was used to describe the relationship between hazard ratio (HR) of death and ACP.ResultsACP assessed at 12 hours (ACP12h) after septic shock [AUROC 0.86 (95% CI 0.79 to 0.93), P < 0.001] demonstrated significantly greater discrimination for 7-day mortality than CI [AUROC 0.67 (95% CI 0.57 to 0.78), P = 0.001 ] and LVEF [AUROC 0.53 (95% CI 0.43 to 0.64), P = 0.58] (all P < 0.001). Similarly, when adjusted with gender, APACHEII score, VIS and MAP as possible confounders, ACP12h still outperformed both CI12h and LVEF for discrimination of 7-day mortality (both P < 0.001). The superior discriminatory performance of ACP12h over both CI12h and LVEF was further maintained when considering ICU mortality and hospital mortality when considered in isolation or adjusted with the baseline prediction. Compared with normal ACP, HR for slight, moderate and severe impairment were 4.84 (1.96 to 11.96), 12.13 (4.83 to 30.43) and 32.70 (7.76 to 137.86), respectively. After adjustment for risk factor, decrease ACP still associated with increasing 7-day mortality (P = 0.001). Exponential relationship was observed between ACP12h and HR of 7-day death.ConclusionsOur results suggested that ACP may serve as a new tool for diagnosing SCM. In addition, the assessment of ACP at 12 hours after septic shock in ICU significantly improves 7-day mortality, ICU mortality and hospital mortality predictions when compared to CI and LVEF.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Accuracy of the Afterload-related Cardiac Performance for 7-day Mortality Among Critical Ill Patients With Septic Shock

Chen

Tao

et al. 2020

Preprint

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“…However, common indicators, such as central venous pressure (CVP) and pulmonary capillary wedge pressure (PCWP), cannot accurately reflect volume status because they are affected by myocardial compliance, ventilator, respiratory movement, and thoracic and abdominal pressure ( 4 , 5 ). While indicators measured using a pulmonary artery catheter are the gold standard, this method’s application is limited due to safety concerns and cost considerations.…”

Section: Introductionmentioning

confidence: 99%

“…Advances in technology have resulted in new procedures, such as pulse-induced contour cardiac output (PiCCO), which can offer precise monitoring of cardiovascular functions and hemodynamic parameters ( 6 – 8 ). Compared to the traditional invasive right heart catheterization, PiCCO has the advantages of simple operation, safety, and long indwelling time ( 4 , 5 ). In addition, thoracic electrical bioimpedance (TEB) and transthoracic echocardiography are two commonly used methods for non-invasive hemodynamic monitoring ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Safety and efficacy of pulse-induced contour cardiac output monitoring in elderly patients with coronary artery disease and severe heart failure at coronary care units

Li-ping

Liu

Changming

et al. 2022

Front. Cardiovasc. Med.

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BackgroundThe optimal treatment for elderly patients with severe heart failure depends on the accurate assessment of their hemodynamic status. Due to its less invasive nature, the safety and efficacy of invasive pulse-induced contour cardiac output (PiCCO)-based hemodynamic monitoring remains uncertain.MethodsThis was a prospective observational study. Between January 2016 and July 2020, 190 elderly patients with severe heart failure were consecutively enrolled. The PiCCO group (89 patients) and non-invasive hemodynamic monitoring group (101 patients) were observed. Hospital stays results were evaluated.ResultsNo significant difference in clinical data (P > 0.05) or the incidence of 1-month mortality (16.0 vs. 35.0%, P = 0.141) were observed between groups. The coronary care unit (CCU) stay was shorter in the PiCCO group than in the non-invasive group (40.0 vs. 43.0%, P = 0.049). Indicators such as low Extravascular Lung Water Index (EVLWI), high Body Mass Index (BMI), low Pulmonary Artery Pressure (PAP), and high Left Ventricular Ejection Time (LVET), were associated with favorable clinical results.ConclusionEarly invasive PiCCO monitoring is safe in critically ill elderly patients with severe heart failure. The hospital stay was reduced using PiCCO monitoring. These encouraging PiCCO results favor its use in elderly patients with severe heart failure at CCUs.

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Role of the lectin-like domain of thrombomodulin in septic cardiomyopathy

et al. 2022

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Cardiovascular Parameters Associated With Troponin I as Indicators for 14-Day Mortality in Patients With Septic Shock

Cited by 8 publications

References 35 publications

Prognostic Accuracy of the Afterload-related Cardiac Performance for 7-day Mortality Among Critical Ill Patients With Septic Shock

Prognostic Accuracy of the Afterload-related Cardiac Performance for 7-day Mortality Among Critical Ill Patients With Septic Shock

Safety and efficacy of pulse-induced contour cardiac output monitoring in elderly patients with coronary artery disease and severe heart failure at coronary care units

Role of the lectin-like domain of thrombomodulin in septic cardiomyopathy

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