Vallabhajosyula S, et al. - This study examined the link between right ventricular dysfunction and clinical outcomes in patients with severe sepsis and septic shock. Researchers reported a common prevalence of isolated right ventricular dysfunction in sepsis and septic shock and as well its relation to worse long-term survival.

Methods

• Researchers performed a historical cohort study including adult patients admitted to all intensive care units at the Mayo Clinic from January 1, 2007 through December 31, 2014 for severe sepsis and septic shock, who had an echocardiogram performed within 72 h of admission.
• They excluded patients with prior heart failure, cor-pulmonale, pulmonary hypertension and valvular disease.
• Right ventricular dysfunction was defined by the American Society of Echocardiography criteria.
• One-year survival, in-hospital mortality and length of stay were the outcomes.

Results

• Findings reported presence of right ventricular dysfunction in 214 (55%) of 388 patients who met the inclusion criteria—isolated right ventricular dysfunction was seen in 100 (47%) and combined right and left ventricular dysfunction in 114 (53%).
• Researchers observed that the baseline characteristics were similar between cohorts except for the higher mechanical ventilation use in patients with isolated right ventricular dysfunction.
• They also noted that echocardiographic findings displayed lower right ventricular and tricuspid valve velocities in patients with right ventricular dysfunction and lower left ventricular ejection fraction and increased mitral E/e' ratios in patients with combined right and left ventricular dysfunction.
• In addition, data reported that after adjustment for age, comorbidity, illness severity, septic shock and use of mechanical ventilation, isolated right ventricular dysfunction was independently associated with worse 1-year survival—hazard ratio 1.6 [95% confidence interval 1.2–2.1; p = 0.002) in patients with sepsis and septic shock.