The role of noninvasive hemodynamic monitoring in the early evaluation of patients affected by sepsis and septic shock in the Emergency Department.

Angela Gravina; Veronica Carosi; Alessia Tiroli; Antonella Brandi; Germano Giovagnoli; Vito NicolaDi Lecce; Emanuele Caredda; Leonardo Palombi; Patrizio Polisca; Jacopo Maria Legramante

Volume : IV, Issue : VIII, August - 2015

The role of noninvasive hemodynamic monitoring in the early evaluation of patients affected by sepsis and septic shock in the Emergency Department.

Angela Gravina, Veronica Carosi, Alessia Tiroli, Antonella Brandi, Germano Giovagnoli, Vito Nicoladi Lecce, Emanuele Caredda, Leonardo Palombi, Patrizio Polisca, Jacopo Maria Legramante

Abstract :

Septic patients admitted to the Emergency Department of a teaching hospital, underwent noninvasive continuous monitoring through Nexfin�, which allows to derive patients hemodynamic profile.Of 80 patients included in the study,48 died (60%). Survivors showed higher mean values of stroke volume (P= 0,001), cardiac output (P=0,005), cardiac index (P= 0,004) and left ventricle contractility index (P=0,002) than nonsurvivors.In the same subjects also the BMI was higher than in nonsurvivors (P=0,014), as well as the lactate levels (P= 0,029). Analysis of each of these variables showed a positive correlation with survival. Considering the relation between all the above mentioned variables taken together and the risk of death it is evident that a dP/dTmax and a BMI lower than the median value increase the death risk.The noninvasive hemodynamic monitoring has shown to be useful in the early stratification of patients with sepsis and septic shock in Emergency Department.