The impact of cardiac dysfunction on acute respiratory distress syndrome and mortality in mechanically ventilated patients with severe sepsis and septic shock: An observational study

Brian M Fuller; Nicholas M Mohr; Thomas J Graetz; Isaac P Lynch; Matthew Dettmer; Kevin Cullison; Talia Coney; Swetha Gogineni; Robert Gregory

doi:10.1016/j.jcrc.2014.07.027

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The impact of cardiac dysfunction on acute respiratory distress syndrome and mortality in mechanically ventilated patients with severe sepsis and septic shock: An observational study

Journal article

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The impact of cardiac dysfunction on acute respiratory distress syndrome and mortality in mechanically ventilated patients with severe sepsis and septic shock: An observational study

Brian M Fuller, Nicholas M Mohr, Thomas J Graetz, Isaac P Lynch, Matthew Dettmer, Kevin Cullison, Talia Coney, Swetha Gogineni and Robert Gregory

Journal of critical care, Vol.30(1), pp.65-70

02/2015

DOI: 10.1016/j.jcrc.2014.07.027

PMCID: PMC4268016

PMID: 25179413

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https://www.ncbi.nlm.nih.gov/pmc/articles/4268016View

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Abstract

Acute respiratory distress syndrome (ARDS) is associated with significant mortality and morbidity in survivors. Treatment is only supportive, therefore elucidating modifiable factors that could prevent ARDS could have a profound impact on outcome. The impact that sepsis-associated cardiac dysfunction has on ARDS is not known. In this retrospective observational cohort study of mechanically ventilated patients with severe sepsis and septic shock, 122 patients were assessed for the impact of sepsis-associated cardiac dysfunction on incidence of ARDS (primary outcome) and mortality. Sepsis-associated cardiac dysfunction occurred in 44 patients (36.1%). There was no association of sepsis-associated cardiac dysfunction with ARDS incidence (p= 0.59) or mortality, and no association with outcomes in patients that did progress to ARDS after admission. Multivariable logistic regression demonstrated that higher BMI was associated with progression to ARDS (adjusted OR 11.84, 95% CI 1.24 to 113.0, p= 0.02). Cardiac dysfunction in mechanically ventilated patients with sepsis did not impact ARDS incidence, clinical outcome in ARDS patients, or mortality. This contrasts against previous investigations demonstrating an influence of nonpulmonary organ dysfunction on outcome in ARDS. Given the frequency of ARDS as a sequela of sepsis, the impact of cardiac dysfunction on outcome should be further studied.

Acute respiratory distress syndrome

Sepsis

Cardiac dysfunction

Details

Title: Subtitle: The impact of cardiac dysfunction on acute respiratory distress syndrome and mortality in mechanically ventilated patients with severe sepsis and septic shock: An observational study
Creators: Brian M Fuller - Department of Anesthesiology, Division of Critical Care, Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO
Nicholas M Mohr - Department of Emergency Medicine, Department of Anesthesiology, Division of Critical Care, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA
Thomas J Graetz - Department of Anesthesiology, Division of Critical Care, Division of Cardiothoracic Anesthesiology, Washington University School of Medicine, St Louis, MO
Isaac P Lynch - Department of Anesthesiology, Division of Critical Care, Division of Cardiothoracic Anesthesiology, Washington University School of Medicine, St Louis, MO
Matthew Dettmer - Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO
Kevin Cullison - Division of Emergency Medicine, Washington University School of Medicine, St Louis, MO
Talia Coney - Saint Louis University School of Medicine, St Louis, MO
Swetha Gogineni - Saint Louis University School of Medicine, St Louis, MO
Robert Gregory - Southern Illinois University School of Medicine, Springfield, IL
Resource Type: Journal article
Publication Details: Journal of critical care, Vol.30(1), pp.65-70
DOI: 10.1016/j.jcrc.2014.07.027
PMID: 25179413
PMCID: PMC4268016
NLM abbreviation: J Crit Care
ISSN: 0883-9441
eISSN: 1557-8615
Publisher: Elsevier Inc
Grant note: UL1 TR000448; TL1 TR000449 / National Institutes of Health (http://dx.doi.org/10.13039/100000002)
Language: English
Date published: 02/2015
Academic Unit: Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
Record Identifier: 9984025263902771

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