Myocardial Injury in Sepsis

SUMMARY:

  • Sepsis induced myocardial QT prolongation is a serious complication.

  • Sepsis is an independent predictor for the development of prolonged QT interval.

  • New onset QT interval in sepsis had higher arrhythmias and 30 day mortality.

REVIEW: 

Liu et al Critical Care 2024;28:115 doi.org/10.1186/s13054-024-04879-2

  • Retrospective review of sepsis patients from 2018 – 2022 with sepsis-3 definition.

  • 1,024 patients (3.3% from ICU).

  • QT Prolongation (QTP occurred in 235 (22.9%) of patients.

  • QTP Risk Factors
    • Coronary Artery Disease
    • Septic Shock
    • Acute Heart Failure
    • Acute Kidney Injury
    • Acute Respiratory Failure

  • QTP was statistically related to:

    • Clinical Characteristics
      • Higher Age
      • Lower Body Surface Area
      • Hypertension
      • Coronary Artery Disease
      • Structural Heart Disease
      • Renal Insufficiency
      • Chronic Obstructive Pulmonary Disease

  • Myocardial Characteristics

    • Higher Sinus Heart Rate
    • Wider QRS Width
  • Clinical Outcomes
    • Higher 30-day mortality

CONCLUSIONS:

  • Occurrence of QTP in sepsis patients is 22.9%.

  • Development of QTP in patients with sepsis is an independent predictor of 30 day mortality.

  • Patients with sepsis and QTP had an increased incidence of atrial and ventricular arrhythmias during hospitalization.

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Erkan Hassan is the Co-Founder & Chief Clinical Officer of Sepsis Program Optimization where he designs & oversees the implementation of solutions to optimize sepsis programs.

To discuss your organization’s Barriers of Effective Sepsis Care, contact Erkan by phone (844) 4SEPSIS (844-473-7747), email (erkan@spo.icu), or video chat.