ISSN: 2577-4301
Authors: Tawab YA*
Background and aim: Septic shock is characterized as a life-threatening organ failure resulting from an aberrant host response to infection. Sepsis continues to be the primary cause of mortality in severely ill patients. Sepsis mortality is associated with cardiac dysfunction. This study aims to assess cardiovascular phenotypes in hemodynamic instability resulting from septic shock and their correlation with outcomes. Methods: Analytic-observational cohort research was performed in the Intensive Care Units at Qasr El Eni Hospital and Maadi Hospitals involving 53 persons diagnosed with septic shock. The study lasted six months, from June 1, 2022, to January 30, 2023. Results: The three biomarkers (left ventricular ejection fraction, left ventricular fractional area change, and mitral E wave velocity in cm/s) were independent predictors for cluster 2. The area under the ROC curve for the combination of these three parameters was 0.983. The predictive capacity of combined indicators demonstrated superiority compared to the single measure (P < 0.001). Univariate analysis indicated that the three biomarkers (left ventricular ejection fraction, mitral E wave velocity in cm/s, and right ventricular/left ventricular end-diastolic area) were independent predictors for cluster 4. The amalgamation of these three traits produced a ROC area of 0.836. The predictive efficacy of aggregated indicators surpassed that of an individual index (P=0.001). Conclusion: The examination of various clusters according to shock type and the presence or absence of left ventricular (LV) systolic dysfunction, hyperkinetic profile, right ventricular (RV) failure and persistent hypovolemia demonstrated notable disparities in laboratory and hemodynamic parameters, with LV systolic dysfunction correlating with diminished ScvO2 levels and RV failure linked to elevated central venous pressure. The echocardiographic measurements revealed considerable disparities among the clusters, with patients exhibiting left ventricular systolic dysfunction demonstrating reduced left ventricular ejection fraction, left ventricular fractional area change, and mitral E wave velocity. This study offers significant insights into the clinical profiles and related characteristics of septic shock patients, facilitating the formulation of focused treatment regimens.
Keywords: Autism; Oral Health; General Anesthesia; Hospital Care; Strategies
