Ehrman, Robert R.Favot, Mark J.Harrison, Nicholas E.Khait, LyudmilaOttenhoff, Jakob E.Welch, Robert D.Levy, Phillip D.Sherwin, Robert L.2025-03-312025-03-312022-07-08Ehrman RR, Favot MJ, Harrison NE, et al. Early echocardiographic assessment of cardiac function may be prognostically informative in unresuscitated patients with sepsis: A prospective observational study. PLoS One. 2022;17(7):e0269814. Published 2022 Jul 8. doi:10.1371/journal.pone.0269814https://hdl.handle.net/1805/46687Purpose: The goal of this study was to explore the association cardiac function at Emergency Department (ED) presentation prior to the initiation of resuscitation, and its change at 3-hours, with adverse outcomes in patients with sepsis. Methods: This was a prospective observational study of patients presenting to an urban ED with suspected sepsis. Patients had a point-of-care echocardiogram performed prior to initiation of resuscitation and again 3 hours later. Left-ventricular (LV) parameters recorded included e', and E/e', and ejection fraction (EF); right-ventricular (RV) function was evaluated using tricuspid annular plane systolic excursion (TAPSE). Logistic and generalized linear regression were used to assess the association of echocardiographic parameters and ≥ 2-point increase in SOFA score at 24 hours (primary outcome) and 24-hours SOFA score and in-hospital mortality (secondary outcomes). Results: For ΔSOFA ≥ 2 and 24-hour SOFA score, declining LVEF was associated with better outcomes in patients with greater baseline SOFA scores, but worse outcomes in patients with lower baseline scores. A similar relationship was found for ΔTAPSE at 3 hours. Reduced LVEF at presentation was associated with increased mortality after adjusting for ED SOFA score (odds-ratio (OR) 0.76 (CI 0.60-0.96). No relationship between diastolic parameters and outcomes was found. IVF administration was similar across ΔLVEF/TAPSE sub-groups. Conclusions: Our results suggest that early change in LV and RV systolic function are independently prognostic of sepsis illness severity at 24-hours. Further study is needed to determine if this information can be used to guide treatment and improve outcomes.en-USAttribution 4.0 InternationalEchocardiographySepsisStroke volumeEarly echocardiographic assessment of cardiac function may be prognostically informative in unresuscitated patients with sepsis: A prospective observational studyArticle