Ecais study: inadvertent cardiovascular adverse events in sepsis
Ecais study: inadvertent cardiovascular adverse events in sepsis
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DOI：
10.1016/j.medin.2011.11.008
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发表时间：
2012-07-01
影响因子：
3
通讯作者：
Nieto Estrada, V.H.
中科院分区：
文献类型：
--
作者：
Gómez Duque, M.;Enciso Olivera, C.;Nieto Estrada, V.H.
目的：了解脓毒症不同阶段患者心血管不良事件的发生率。设计：采用纵向、描述性、观察性研究。环境：波哥大（哥伦比亚）两所大学医院的重症监护室。患者：多例患者连续入住成人ICU，诊断为败血症，既往无缺血性心肌损伤证据。干预措施：使用Hotter技术记录48小时心电图。主要变量：缺血、心律失常、心率变异性。结果：共分析100例患者，其中62%分期为感染性休克。3%的人出现了由Hotter检测到的缺血事件，而通过常规监测却未被发现。46%的患者出现了由Hotter检测到的心律失常事件，而传统监测方法仅检测到6%。死亡率为40%。所有患者均表现出心率变异性的丧失。结论：在本研究中，脓毒症患者的心血管缺血事件发生率较低。相反，心律失常的发生率较高。常规监测不能检测到任何缺血事件和大多数心律失常事件。在这项研究中，肾上腺素能释放引起的心血管事件对死亡率没有影响。(C) 2011 Elsevier Espana， S.L.和semiyuc。版权所有。
Objective: To describe the incidence of cardiovascular adverse events in patients with sepsis in its various stages.Design: A longitudinal, descriptive, observational study was carried out.Setting: Intensive care units of two university hospitals in Bogota (Colombia).Patients: A number of patients consecutively admitted to the adult ICU with a diagnosis of sepsis, and no evidence of previous ischemic myocardial injury.Interventions: Forty-eight hours of electrocardiographic record using Hotter technology.Main variables: Ischemia, cardiac arrhythmia, heart rate variability.Results: A total of 100 patients were analyzed, 62% being staged as presenting septic shock. Three percent suffered ischemic events detected by Hotter and unnoticed through conventional monitoring. Forty-six percent suffered an arrhythmic event detected by Hotter, compared with only 6% as detected by conventional monitoring. Mortality was 40%. All patients showed loss of heart rate variability.Conclusion: In this study patients with sepsis showed a low incidence of cardiovascular ischemic events. In contrast, arrhythmic events showed a high incidence. Conventional monitoring failed to detect any of the ischemic events and most arrhythmic events. In this study, cardiovascular events generated by adrenergic discharge had no impact upon mortality. (C) 2011 Elsevier Espana, S.L. and SEMICYUC. All rights reserved.