SESSION TITLE: Critical Care Posters II
SESSION TYPE: Poster Presentations
PRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PM
PURPOSE: We have previously demonstrated in a clinically relevant murine model of sepsis, that a phenotype of left ventricular (LV) dilation was associated with improved cardiovascular performance (stroke volume (SV) and cardiac output (CO)) and increased survival. Using the same model of sepsis, we sought to determine whether survival in mice that did not manifest dilation was associated with a particular phenotype.
METHODS: 94 C57Bl/6 mice were used. 85 septic mice had cecal ligation and puncture followed by fluid and antibiotic resuscitation and 9 control mice received sham ligation. Echocardiography was performed at baseline and every 3 hours after CLP during 72 hours. SV, CO, LV internal diameter in diastole (LVIDd), and fractional shortening (FS) were measured. LV dilation was prospectively defined as an increase in LVIDd≥5% from baseline values. Among non dilators, mice were classified as survivors (alive after 72 hours) and non survivors. We compared SV, CO, LVIDd, FS, heart rate and temperature between these two groups.
RESULTS: Among septic animals, 19% were dilators and 81% were non dilators. In the non dilators group (n=69), 49% of the mice survived. After CLP, SV and CO decreased early in both survivors and non survivors but in survivors, temperature (34.9±1.1°C vs 34.1±1.2°C; p=0.003), SV (24±7.8μL vs 19.4±5.4μL; p=0.005), LVIDd (3.11±0.42mm vs 2.83±0.43mm; p=0.008) and CO (12.4±4.1ml/min vs 10.2±2.9ml/min; p=0.01) were higher than in non survivors after 3 hours and HR (471±69bpm vs. 421±55bpm; p=0.001) was higher after 12 hours. Interestingly, there was no difference for FS between survivors and non survivors.
CONCLUSIONS: In a clinically relevant murine model of sepsis, among animals without LV dilation, we found that survivors develop within the first 3 hours a phenotype defined by higher LV diastolic diameter, SV and CO without improving FS.
CLINICAL IMPLICATIONS: These results suggest that preserved LVIDd is associated with SV and CO improvement, a pattern resulting in greatly improved survival. It highlights the importance of diastolic function in septic shock.
DISCLOSURE: The following authors have nothing to disclose: Fabien Picard, François Depret, Sergio Zanotti-Cavazzoni, Steven Hollenberg
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