title: Cardiac contractile reserve parameters are related to prognosis in septic shock.
abstract: BACKGROUND
  Cardiac reserve could be defined as the spontaneous magnitude from basal to maximal cardiac power under stress conditions. The aim of this study was to evaluate the prognostic value of cardiac reserve parameters in resuscitated septic shock patients.
  
  
  METHODS
  Seventy patients with septic shock were included in a prospective and observational study. Prior to inclusion, patients were resuscitated to reach a mean arterial pressure of 65-75 mmHg with an euvolemic status. General, hemodynamic, and cardiac reserve-related parameters (cardiac index, double product, and cardiac power index) were collected at inclusion and at day 1.
  
  
  RESULTS
  Seventy patients were included with 28-day mortality at 38.5%. Ten of the 70 patients died during the first day. In multivariate analysis, independent predictors of death were SAPS II ≥ 58 (OR: 3.36 [1.11-10.17]; P = 0.032), a high double product at inclusion (OR [95% IC]: 1.20 [1.00-1.45] per 10(3) mmHg · min; P = 0.047), and at day 1, a decrease in cardiac index (1.30 [1.08-1.56] per 0.5 L/min/m(2); P = 0.007) or cardiac power index (1.84 [1.18-2.87] per 0.1 W/m(2), P = 0.008).
  
  
  CONCLUSIONS
  In the first 24 hours, parameters related to cardiac reserve, such as double product and cardiac index evolution, provide crucial and easy to achieve hemodynamic physiological information, which may impact the outcome.
authors: Service de Réanimation Médicale Brabois, CHU de Nancy, 54511 Vandoeuvre les Nancy, France. akimmoun@gmail.com
authors: Antoine
authors: A
authors: Kimmoun
authors: Nicolas
authors: N
authors: Ducrocq
authors: Sébastien
authors: S
authors: Mory
authors: Remi
authors: R
authors: Delfosse
authors: Laura
authors: L
authors: Muller
authors: Pierre
authors: P
authors: Perez
authors: Renaud
authors: R
authors: Fay
authors: Bruno
authors: B
authors: Levy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002316:Cardiotonic Agents; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000401:mortality* / Q000473:pathology; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010101:Oxygen Consumption; D010749:Phosphoprotein Phosphatases / Q000097:blood; D011379:Prognosis; D012772:Shock, Septic / Q000097:blood / Q000401:mortality* / Q000473:pathology
chemical_list: D002316:Cardiotonic Agents; D010749:Phosphoprotein Phosphatases
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