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Medicina Intensiva
versão impressa ISSN 0210-5691
Resumo
GOMEZ DUQUE, M. et al. Ecais study: inadvertent cardiovascular adverse events in sepsis. Med. Intensiva [online]. 2012, vol.36, n.5, pp.343-350. ISSN 0210-5691.
Objective: To describe the incidence of cardiovascular adverse events in patients with sepsis in its various stages. Design: A longitudinal, descriptive, observational study was carried out. Setting: Intensive care units of two university hospitals in Bogotá (Colombia). Patients: A number of patients consecutively admitted to the adult ICU with a diagnosis of sepsis, and no evidence of previous ischemic myocardial injury. Interventions: Forty-eight hours of electrocardiographic record using Holter technology. Main variables: Ischemia, cardiac arrhythmia, heart rate variability. Results: A total of 100 patients were analyzed, 62% being staged as presenting septic shock. Three percent suffered ischemic events detected by Holter and unnoticed through conventional monitoring. Forty-six percent suffered an arrhythmic event detected by Holter, compared with only 6% as detected by conventional monitoring. Mortality was 40%. All patients showed loss of heart rate variability. Conclusion: In this study patients with sepsis showed a low incidence of cardiovascular ischemic events. In contrast, arrhythmic events showed a high incidence. Conventional monitoring failed to detect any of the ischemic events and most arrhythmic events. In this study, cardiovascular events generated by adrenergic discharge had no impact upon mortality.
Palavras-chave : Myocardial ischemia; Ambulatory electrocardiography; Sepsis; Septic shock.