Age-related features of central hemodynamics in sepsis. Article
Issue 4 (2019) , DIAGNOSTIC APPROACHES IN CRITICALLY ILL PATIENTS
Issue 4 (2019)
DIAGNOSTIC APPROACHES IN CRITICALLY ILL PATIENTS

Age-related features of central hemodynamics in sepsis. Article

https://doi.org/10.21320/1818-474X-2019-4-88-97
Published 05.11.2019
Sergey A. Rautbart
City Clinical Hospital named V.M. Buyanov, Moscow, Russia; FUV SBHCI MR “MONIKI named M.F. Vladimirsky”, Moscow, Russia
https://orcid.org/0000-0001-8833-3886
I.N. Tyurin
City Clinical Hospital named V.M. Buyanov, Moscow, Russia; “RNRU named N.I. Pirogov” Ministry of Health of Russia, Moscow, Russia
https://orcid.org/0000-0002-5696-1586
S.N. Shurigin
City Clinical Hospital named V.M. Buyanov, Moscow, Russia; FSBI “Federal Science Center for Physical Culture and Sport”, Moscow, Russia
https://orcid.org/0000-0001-5867-5519
I.A. Kozlov
City Clinical Hospital named V.M. Buyanov, Moscow, Russia; FUV SBHCI MR “MONIKI named M.F. Vladimirsky”, Moscow, Russia
https://orcid.org/0000-0003-1910-0207
#2019-4
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Keywords

sepsis
advanced and senile age
CHD
age-related features of CHD

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Rautbart S.A., Tyurin I.N., Shurigin S.N., Kozlov I.A. Age-related features of central hemodynamics in sepsis. Article. Annals of Critical Care. 2019;(4):88–97. doi:10.21320/1818-474X-2019-4-88-97.
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Abstract

Objective. To study the effect of the age of patients with sepsis on the level of central hemodynamic parameters (CHD) recorded in them upon admission to the intensive care unit and intensive care (ICU).

Materials and methods. Retrospectively analyzed the survey data of 54 patients with sepsis diagnosed in accordance with the criteria of “Sepsis-3”. The age of patients was 22–83 (49.6 ± 2.17) years; the severity of the condition upon admission to ICU on the APACHE II scale of 6–19 (12.3 ± 0.47) points, on the SOFA scale — 4–14 (8 [6.10]) points. In patients with sepsis, a number of indicators characterizing the pumping function of the heart (cardiac function index (CFI), global ejection faction (GEF), cardiac power index (CPI), cardiac index (CI)) are inversely correlated with age, and the global end-diastolic volume Index (GEDI) — in direct connection.

Results. In patients with sepsis, a number of CHD indicators had correlation with age:

CFI — rho = −0.681 (p < 0.0001), GEF — rho = −0.488 (p = 0.0002), CPI — rho = −0.438 (p = 0.0009), CI — rho = −0.395 (p = 0.0031) and GEDI — rho = 0.427 (p = 0.0013). Age > 62 years was a predictor of CFI < 4.5 min-1 (OR 1.1817, 95% CI 1.0642–1.3121; p < 0.0001) and GEF < 20 % (OR 1, 0741, 95% CI 1.0251-1.1255; p < 0.0006). Age > 64 years was a predictor of CI levels < 2.5 L / min / m2 (OR 1.0834, 95% CI 1.0200-1.1508; p < 0.0024). At the age of about 60, the likelihood of a decrease in heart rate and an increase in total peripheral vascular resistance also increased. Patients older than 62 years were more often diagnosed with concomitant hypertension (78 % and 12.5 %; p < 0.001), coronary heart disease (64 % and 7.5 %; p < 0.01) and post-infarction cardiosclerosis (7 % and 0 %; p = 0.02).

Conclusion. The high probability of a decrease in the efficiency of the pumping function of the heart, as well as comorbidity for cardiovascular diseases, should be taken into account when choosing optimal measures for intensive treatment and monitoring in geriatric patients with sepsis.

https://doi.org/10.21320/1818-474X-2019-4-88-97
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