Abstract: Poster Presentations |


Joel E. Pittman, MD*; Colin Grissom, MD; Samuel Brown, MD; Chad Cole, MD; Ellie Hirshberg, MD; Tom White, MD
Author and Funding Information

University of Utah, Salt Lake City, UT


Chest. 2009;136(4_MeetingAbstracts):128S-c-129S. doi:10.1378/chest.136.4_MeetingAbstracts.128S-c
Text Size: A A A
Published online


PURPOSE:  Critical care echocardiography is an emerging practice in the evaluation of cardiac function and volume status in patients in the intensive care unit. A consensus statement defining competence in basic and advanced critical care echocardiography was recently published. We measured whether useful information can be obtained with advanced critical care echocardiography in the setting of severe sepsis and septic shock.

METHODS:  Within the first 6 hours of presentation with severe sepsis or septic shock we evaluated diastolic function using pulse wave Doppler of mitral valve inflow and tissue Doppler of the mitral annulus and we measured the ratio of early diastolic mitral inflow velocity (E) to tissue Doppler mitral annulus velocity (Ea). We measured left ventricular (LV) ejection fraction (LVEF) using the method of disks. We assessed right ventricular (RV) function by tricuspid annular plane systolic excursion (TAPSE). We calculated the percentage of time we were able to obtain these echocardiographic parameters.

RESULTS:  24 patients were enrolled in the study. 54% were men. There was a 21% mortality rate. Adequate images were obtained to measure LVEF in 88% of patients; 24% of these patients had LV systolic dysfunction using a threshold of LVEF < 45%. We were able to define diastolic function by standard criteria in 75% of patients; the other 25% had either fused diastology or inadequate images. In 3 patients, E/Ea was greater than 15; 2 of these patients had restrictive diastolic physiology and 1 had impaired relaxation. Adequate images were obtained to measure RV function in 96% of patients; 26% of these patients had RV dysfunction defined by a TAPSE < 15mm. Only 1 patient had both LV and RV dysfunction.

CONCLUSION:  Parameters of cardiac function can be reliably obtained using advanced critical care echocardiography in patients with severe sepsis and septic shock.

CLINICAL IMPLICATIONS:  Findings from advanced critical care echocardiography may have implications for treatment of patients with severe sepsis and septic shock.

DISCLOSURE:  Joel Pittman, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

12:45 PM - 2:00 PM




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
PubMed Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543