The Role of Left Ventricular Outflow Tract Peak Velocity Measurement in Patients With Sepsis and Septic Shock

Abstract

To determine whether left ventricular outflow tract peak velocity is useful for the prediction of mortality in the early phase of sepsis or septic shock. Materials and methodsPatients who were hospitalized in the emergency intensive care unit (ED-ICU) with the diagnosis of sepsis or septic shock were consecutively enrolled into two groups (sepsis and septic shock groups) between January 2020 to February 2021. Patients who are pregnant and ≤18 years old were excluded. Demographics, vital parameters, the presence of mechanical ventilation, and vasopressor/inotropic support with the doses of the drugs used were recorded. Ultrasonographic measurements included bedside caval indexes and left ventricular outflow tract (LVOT) peak velocity measurements. The primary outcome was in-hospital and 28th-day mortality. ResultsA total of 116 patients with a median age of 72.5 (27 to 96) years were enrolled. Sixty-eight (58.6%) patients were male. According to a receiver operating characteristic (ROC) curve analysis, 75 cm/s was determined as a cut-off value to determine the efficacy of LVOT peak velocity measurement for discriminating septic shock from sepsis and predicting 28-day and in-hospital mortality. The patients were then regrouped as 54 (46.5%) patients in low and 62 (53.5%) patients in high-velocity groups according to the cut-off value. Both inhospital and 28th-day mortality rates were significantly different between these groups (p<0.001). ConclusionLeft ventricular outflow tract peak velocity measurement may be a useful adjunct for the prediction of mortality in septic patients. Vasopressors and volume status of the patient do not affect LVOT peak velocity measurements.