The use of cardiac ECHO for prediction of an outcome in septic shock patients

Completed

Brief Summary: Sepsis induced cardiac dysfunction is well known complication in patients with septic shock, with Incidence rate around 40-50%and associated with high mortality. Multiple invasive parameters(SVR,CO/CI, by TPTD, flow trac,etc)serum Biomarkers- procalcitonin, NT proBNP, cardiac troponins (I & T), CRP etc and non invasive parameters( ECHO for systolic and diastolic dysfunction)used to predict severity and outcome. All parameters have some limitations; none of these are accurate independent predictors. A new ECHO parameter, myocardial performance index which indicates both systolic and diastolic function of the heart and is independent of heart rate, preload and afterload conditions of the heart, so it can be more correlated with sepsis induced cardiomyopathy changes. Previous studies have compared serum biomarkers with either systolic/diastolic dysfunction or ejection fraction in septic shock patients. MPI as a non-invasive and quick bedside measure can equally or more superiorly be used to predict the 28 day mortality. And we assume that MPI can be correlated well with Serum Trop-I and NTproBNP.

Recruitment & Eligibility

Inclusion Criteria

1.All non-pregnant patients 18 -75 years of age who met the Surviving Sepsis Campaign-2021 definition of septic shock.

Exclusion Criteria

1.Refusal of consent 2.Patient with septic shock who has received treatment at another hospital and later referred to AIIMS.
3.Atrial or ventricular arrhythmias, including bundle branch blocks and frequent premature ventricular contractions.
4.Known or new onset valvular disease.
5.Suspected infective endocarditis.
Acute coronary syndrome 7.Cor pulmonale or COPD.
8.Acute renal failure at presentation 9.Pregnant patients.

Primary Outcome Measures

Name	Time	Method
To predict the 28 day mortality in septic shock patients by using the myocardial performance index.	To measure the myocardial performance index at enrolment (0hours) ,24 hours . \| Assessing the patient status at 28 day after enrolment.

Secondary Outcome Measures

Name	Time	Method
Whether there is correlation between MPI and Trop-I,NT- proBNP in septic shock patients.	To measure the Trop-I,NT- proBNP at enrolment and 24 hours later.
To predict the length of hospital stay,	-Length of ICU stay,

Locations (1): AIIMS HOSPITAL, NEW DELHI
🇮🇳
South, DELHI, India
AIIMS HOSPITAL, NEW DELHI
🇮🇳South, DELHI, India
Dr Bankar Prashant Lalaso
Principal investigator
9910659461
pradhantbankar15@gmail.com