Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure

• Main Author: Randa Soliman
• Format: Article
• Language: English
• Published: Wolters Kluwer 2017-08-01
• Series: Egyptian Journal of Critical Care Medicine
• Online Access: http://www.sciencedirect.com/science/article/pii/S2090730317300063

Prediction of fluid status and survival by electrical cardiometry in septic patients with acute circulatory failure. Background: Septic hemodynamic instability imposes challenges to critical care physician in deciding fluid management to optimize preload dependency state. Methods: Thirty patients with severe sepsis and hypotension (Mean arterial pressure i.e. MAP < 65 mmHg) and evidence of tissue hypotension i.e. lactate level ≥4 mmol/L were enrolled in our study. Fluid resuscitation (30 ml/kg) was administered. Fluid response was defined as MAP ≥ 65 mmHg with lactate level <4 mmol/L cardiac output (CO), measured by electrical cardiometry, in guiding fluid therapy. Results: The study included 13 males (43.3%) with age 47.8 ± 19.7. Paired comparison showed significant change in MAP readings (P value < 0.001). ROC curve showed cutoff 12.5% for delta CO to predict fluid responsiveness with Area under Curve (AUC) 0.927, sensitivity 90.0%, and specificity 70.0%. ROC also showed delta CO cutoff 12.5% to predict survival with AUC 0.756, sensitivity 66.7% and specificity 66.7%. Conclusion: Delta change in cardiac output, measured by electric cardiometry could be used to predict fluid response and survival in acute circulatory failure in septic critically ill patients.