It is my personal opinion that sepsis-induced cardiomyopathy has been under recognized and understudied. Our current practice pattern of starting patients on norepinephrine is good. But automatically going to vasopressin, then either phenylephrine or epinephrine as they continue to deteriorate overlooks the fact that they may have sepsis-induced cardiomyopathy. Going down the typical route we could be generating too much SVR (systemic vascular resistance) at the expense of an already low cardiac output. But what is the prevalence of sepsis-induced cardiomyopathy anyway? This is what these authors sought out. Hat tip to them. Read these data for yourself.
They performed a systematic review and meta-analysis. The prevalence of SICM was 20%. One in five patients could potentially be mismanaged if not recognized. It was no surprise that these patients had a poor prognosis and higher mortality. This is something we really need to think about more often in septic patients. Do you regularly assess the cardiac function of septic patients?
Click here for additional an article on using Vitamin B12 for sepsis.
Citation for Sepsis Induced Cardiomyopathy
Hasegawa D, Ishisaka Y, Maeda T, Prasitlumkum N, Nishida K, Dugar S, Sato R. Prevalence and Prognosis of Sepsis-Induced Cardiomyopathy: A Systematic Review and Meta-Analysis. J Intensive Care Med. 2023 Jun 4:8850666231180526. doi: 10.1177/08850666231180526. Epub ahead of print. PMID: 37272081.
Link to Article (NOT FREE)
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