Speckle Tracking Algorithm-Based Ultrasonic Cardiogram in Evaluation of the Efficacy of Dexmedetomidine Combined with Bundle Strategy on Patients with Severe Sepsis

Abstract

The research aimed to study the effect of dexmedetomidine combined with bundle strategy on the cardiac function of patients with severe sepsis through pyramid speckle tracking algorithm-based echocardiography, expected to provide reference for its clinical treatment. 98 patients with severe sepsis or septic shock admitted to the hospital were selected as the research subjects, and they were equally divided into experimental group (dexmedetomidine + bundle strategy) and control group (dexmedetomidine + routine nursing), with 49 in each. Ultrasonic cardiogram examination was performed on patients before and after treatment, and the pyramid-based speckle tracking (PST) algorithm was designed and used. The results showed that the running time of the PST algorithm (105.25 s) was less than that of the BM algorithm (336.41 s), and the difference was statistically significant ( P < 0.05 ), and the systolic blood pressure, diastolic blood pressure, left ventricular wall, and heart rate of the experimental group before treatment were not significantly different from those of the control group ( P > 0.05 ). The ultrasound index results found that the ejection fraction (EF) and fractional shortening (FS) of the two groups of patients showed a downward trend over time (1–7 days), while the E/A ratio showed an upward trend, and the E/A ratio of the experimental group was significantly greater than the control group ( P < 0.05 ). The systolic blood pressure, diastolic blood pressure, left ventricular wall, and heart rate of the two groups of patients showed a downward trend over time (1–7 days), and the systolic blood pressure, diastolic blood pressure, left ventricular wall, and heart rate of the experimental group were significantly lower than those of the control group ( P < 0.05 ). The 28-day mechanical ventilation time (6.97 ± 3.11 days), intensive care unit (ICU) stay time (9.18 ± 2.86 days), and the 28-day mortality rate (15.31%) of the experimental group were lower than those of the control group (6.97 ± 3.11 days; 13.08 ± 2.53 days; 31.95%) ( P < 0.05 ). In conclusion, the PST algorithm can effectively improve the quality of echocardiography and assist physicians in clinical evaluation, and dexmedetomidine combined with bundle strategy can stabilize the heart rate and reduce myocardial oxygen consumption in severe sepsis, while effectively shortens the recovery time and improves the overall prognosis.

Effect of ICU care bundles on long-term patient-relevant outcomes: a scoping review

“…Articles were published between 2000 and 2022, with half of the studies (n=19) published in 2016 or later. They were conducted in the US (n=15),39–53 France (n=4),54–57 Australia (n=5),58–62 China (n=3),63–65 Spain (n=2),66 67 Norway (n=2),68 69 Scotland,70 Portugal,71 Northern Ireland,72 Italy,73 Germany,74 Canada75 and Uganda (each n=1) 76. Two studies depict separate outcome analyses of data collected within one clinical trial (ClinicalTrials.gov identifier: NCT01656317).…”

“…Two studies depict separate outcome analyses of data collected within one clinical trial (ClinicalTrials.gov identifier: NCT01656317). 68 69 We identified 19 single-centre studies,39–41 44 45 47 49 50 52 56 62–64 68 69 72–75 three two-centre studies,43 57 76 and 16 multicentre studies 42 46 48 51 53–55 58–61 65–67 70 71. Thirty studies were prospective,39–45 48 51–59 61 62 64–69 71–73 75 76 and eight studies were retrospective 46 47 49 50 60 63 70 74.…”

“…68 69 We identified 19 single-centre studies,39–41 44 45 47 49 50 52 56 62–64 68 69 72–75 three two-centre studies,43 57 76 and 16 multicentre studies 42 46 48 51 53–55 58–61 65–67 70 71. Thirty studies were prospective,39–45 48 51–59 61 62 64–69 71–73 75 76 and eight studies were retrospective 46 47 49 50 60 63 70 74. Eight studies were observational cohort studies,50 53 59 63 65 66 70 71 21 studies were quasi-experimental before–after studies,39–41 43–47 49 54–58 67–69 73–76 1 study was a quasi-experimental single-arm study (which compared patients from the early and late implementation phases of a bundle intervention),51 1 study was a quasi-experimental controlled non-randomised comparative time-series study,72 1 study was a cost-effectiveness analysis,42 5 studies were randomised controlled trials (RCTs) (one cluster RCT and 4 individually RCTs)48 52 61 62 64 and 1 study was a quasi-experimental trial following an RCT 60.…”

“…Eleven studies investigated the implementation of a sepsis bundle based on recommendations from the Surviving Sepsis Campaign or similar 44 45 54 63–67 71 74 76. Nine studies explored combined bundles, including five studies on the ABCDE(F) bundle,41–43 53 62 one study on geriatric-focused practices,50 two studies on a fever, sugar and swallowing bundle60 61 and one study comprising delirium and sedation management, mobilisation and rounding strategies 46.…”

“…Almost two-thirds (n=24) of the studies reported survival after hospital discharge, most commonly 28-day,44–46 54 63–67 71 76 30-day,48 70 74 75 60-day,63 90-day,57 61 63 69 180-day,59 70 1 year,42 56 68 or 3–5 year mortality,60 or survival to discharge from acute and rehabilitative care to home and mortality in the rehabilitation facility39 (tables 1 and 3).…”