Association of left ventricular longitudinal strain with central venous oxygen saturation and serum lactate in patients with early severe sepsis and septic shock

Critical Care : the Official Journal of the Critical Care Forum
Michael J LanspaColin K Grissom


In septic shock, assessment of cardiac function often relies on invasive central venous oxygen saturation (ScvO2). Ventricular strain is a non-invasive method of assessing ventricular wall deformation and may be a sensitive marker of heart function. We hypothesized that it may have a relationship with ScvO2 and lactate. We prospectively performed transthoracic echocardiography in patients with severe sepsis or septic shock and measured (1) left ventricular longitudinal strain from a four-chamber view and (2) ScvO2. We excluded patients for whom image quality was inadequate or for whom ScvO2 values were unobtainable. We determined the association between strain and ScvO2 with logistic and linear regression, using covariates of mean arterial pressure, central venous pressure, and vasopressor dose. We determined the association between strain and lactate. We considered strain greater than -17% as abnormal and strain greater than -10% as severely abnormal. We studied 89 patients, 68 of whom had interpretable images. Of these patients, 42 had measurable ScvO2. Sixty percent of patients had abnormal strain, and 16% had severely abnormal strain. Strain is associated with low ScvO2 (linear coefficient -1.05, p =0.006; odds ratio 1.23 f...Continue Reading


Oct 1, 1985·Critical Care Medicine·W A KnausJ E Zimmerman
Jan 1, 1984·Annales Françaises D'anesthèsie Et De Rèanimation·J J LehotJ Motin
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Jan 17, 2002·The New England Journal of Medicine·Emanuel P RiversEarly Goal-Directed Therapy Collaborative Group
Aug 2, 2006·Critical Care : the Official Journal of the Critical Care Forum·Paul W G Elbers, Can Ince
Jan 11, 2007·Critical Care : the Official Journal of the Critical Care Forum·Hendrik BrachtStephan M Jakob
Sep 22, 2007·Critical Care Medicine·Richard J Levy, Clifford S Deutschman
Sep 29, 2007·Critical Care Clinics·Paul E Marik, Michael Baram
May 23, 2008·Critical Care Medicine·Antoine Vieillard-BaronFrançois Jardin
Jun 27, 2009·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Ken SaitoKiyoshi Yoshida
Aug 12, 2009·European Journal of Echocardiography : the Journal of the Working Group on Echocardiography of the European Society of Cardiology·Erwan DonalGeneviève Derumeaux
Feb 25, 2010·JAMA : the Journal of the American Medical Association·Alan E JonesEmergency Medicine Shock Research Network (EMShockNet) Investigators
Mar 17, 2011·Circulation. Cardiovascular Imaging·Brian D Hoit
Mar 1, 2012·Archives of Cardiovascular Diseases·Romain GalletPascal Lim
Aug 23, 2012·Chest·Samuel M BrownAlan H Morris
Dec 12, 2012·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Teerapat YingchoncharoenThomas H Marwick
Jan 29, 2013·Critical Care Medicine·R Phillip DellingerSurviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup
Mar 19, 2014·The New England Journal of Medicine·Donald M YealyDerek C Angus
Jul 13, 2014·Critical Care : the Official Journal of the Critical Care Forum·Sam R OrdeJae K Oh
Oct 2, 2014·The New England Journal of Medicine·Sandra L PeakePatricia Williams


Jul 2, 2016·Critical Care : the Official Journal of the Critical Care Forum·H Bryant NguyenEmanuel P Rivers
Mar 24, 2017·Journal of Intensive Care·Ahmed HasaninHeba Nassar
Dec 12, 2017·Critical Care Medicine·Sarah J BeesleySamuel M Brown
Mar 23, 2018·The International Journal of Artificial Organs·Khosrow Siamak HouschyarFrank Siemers
Mar 31, 2018·Echocardiography·Antonello D'AndreaWorking Group on Echocardiography of the Italian Society of Cardiology
Oct 28, 2019·Intensive Care Medicine Experimental·Meghan M CirulisSamuel M Brown
Mar 11, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Bereketeab HaileselassieTheodore Abraham
Mar 14, 2019·International Anesthesiology Clinics·Vivian Hernandez-TorresJose L Diaz-Gomez
Jan 24, 2018·Anaesthesia and Intensive Care·Saraschandra VallabhajosyulaJacob C Jentzer
Aug 21, 2018·Pilot and Feasibility Studies·Samuel M BrownEsmolol to Control Adrenergic Storm in Septic Shock-ROLL-IN (ECASSS-R) study
Mar 20, 2018·Journal of Intensive Care Medicine·Saraschandra VallabhajosyulaJacob C Jentzer

Related Concepts

Diastolic Blood Pressure
2D Echocardiography
Endotoxic Shock
Left Ventricular Function
Ammonium lactate
Biological Markers
Septic Shock

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Synthetic Genetic Array Analysis

Synthetic genetic arrays allow the systematic examination of genetic interactions. Here is the latest research focusing on synthetic genetic arrays and their analyses.

Congenital Hyperinsulinism

Congenital hyperinsulinism is caused by genetic mutations resulting in excess insulin secretion from beta cells of the pancreas. Here is the latest research.

Neural Activity: Imaging

Imaging of neural activity in vivo has developed rapidly recently with the advancement of fluorescence microscopy, including new applications using miniaturized microscopes (miniscopes). This feed follows the progress in this growing field.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Epigenetic Memory

Epigenetic memory refers to the heritable genetic changes that are not explained by the DNA sequence. Find the latest research on epigenetic memory here.

Cell Atlas of the Human Eye

Constructing a cell atlas of the human eye will require transcriptomic and histologic analysis over the lifespan. This understanding will aid in the study of development and disease. Find the latest research pertaining to the Cell Atlas of the Human Eye here.

Femoral Neoplasms

Femoral Neoplasms are bone tumors that arise in the femur. Discover the latest research on femoral neoplasms here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Related Papers

Critical Care : the Official Journal of the Critical Care Forum
Julien TextorisMarc Leone
Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Michael A PuskarichEmergency Medicine Shock Research Network (EMShockNet) Investigators
© 2021 Meta ULC. All rights reserved