Transthoracic echocardiographic versus cardiometry derived indices in management of septic patients

Figures & data

Figure 1. CONSORT flow chart

Table 1. Comparison between the three studied groups according to age, sex and cause of sepsis

	Cardiometry (n = 30)	Echo (n = 30)	EGDT (n = 30)	p
Age (year)
Mean ± SD.	38.5 ± 3.3	38.6 ± 3.3	39.4 ± 3.7	0.497
Sex
Male	17(56.7%)	17(56.7%)	16(53.3%)	0.956
Female	13(43.3%)	13(43.3%)	14(46.7%)
Causes of sepsis
Abscess	6(20%)	3(10%)	5(16.7%)	0.980
Bronchiectasis	5(16.7%)	5(16.7%)	4(13.3%)
Endocarditis	5(16.7%)	6(20%)	4(13.3%)
Peritonitis	7(23.3%)	7(23.3%)	7(23.3%)
Pneumonia	7(23.3%)	9(30%)	10(33.3%)

χ2: Chi square test, F: F for ANOVA test. EGDT: early goal directed therapy, SD: standard deviation.

Table 2. Comparison between the three studied groups according to mortality

	Cardiometry (n = 30)	ECHO (n = 30)	EGDT (n = 30)	Test of Sig.	P value
Mortality
Died	9(30.0%)	7(23.3%)	17(56.7%)	χ^2 = 8.038*	0.018*
Lived	21(70.0%)	23(76.7%)	13(43.3%)
P value	p1 = 0.559, p2 = 0.037*,p3 = 0.008*

χ2: Chi square test, F: F for ANOVA test. EGDT: early goal directed therapy, SD: standard deviation, p: p value for comparing between the studied groups, p1: p value for comparing between Cardiometry and ECHO, p2: p value for comparing between Cardiometry and Fluid, p3: p value for comparing between ECHO and Fluid, *denote statistically significant at p ≤ 0.05

Table 3. Comparison between the three studied groups according to hospital stay, ICU stay, vasopressor duration, mechanical ventilation duration, dobutamine dose and norepinephrine dose

	Cardiometry (n = 30)	Echo (n = 30)	EGDT (n = 30)	p
Hospital stay (day)				p1 = 0.887, p2 = 0.013* p3 = 0.019*
Mean ± SD.	12.6 ± 2.1	12.1 ± 2.8	10.3 ± 3.0
ICU stay (day)				p1 = 0.715, p2 = 0.003* p3 = 0.030*
Mean ± SD.	10.0 ± 2.6	10.4 ± 3.8	8.1 ± 2.0
Vasopressor duration (hour)				p1 = 0.992, p2 < 0.001* p3 < 0.001*
Mean ± SD.	40.8 ± 11.5	41.1 ± 12.0	23.2 ± 3.7
Mechanical ventilation (day)				p1 = 0.724, p2 = 0.003* p3 = 0.010*
Mean ± SD.	6.2 ± 3.5	6.5 ± 4.7	3.7 ± 2.5
Fluid (ml)				p1 = 0.883, p2 < 0.001* p3 < 0.001*
Mean ± SD.	2569.0 ± 330.0	2517.0 ± 364.3	3583.9 ± 543.6
Median (Min. – Max.)	2545(2050–3490)	2470(2000–3400)	3615(2456–4500)
Dobutamine dose (µg/kg/h)				p1 = 0.885, p2 = 0.023* p3 = 0.033*
Mean ± SD.	6.3 ± 5.0	6.2 ± 5.5	3.6 ± 3.9
Norepinephrine dose (µg/kg/h)				p1 = 0.573, p2 = 0.006* p3 = 0.030*
Mean ± SD.	0.216 ± 0.097	0.203 ± 0.099	0.157 ± 0.122

^{*denote significant, p: p value for comparing between the studied groups, p1: p value for comparing between cardiometry and Echo, p2: p value for comparing between cardiometry and EGDT, p3: p value for comparing between Echo and EGDT. EGDT, early goal directed therapy, ICU: intensive care unit, SD: standard deviation, Min: minimum, Max: maximum.}

Table 4. Comparison between the three studied groups according to APACHI II score, lactate, HR, MAP, CVP & SPO2 either between the three groups or within same group between before and after treatment

		Cardiometry (n = 30)	Echo (n = 30)	EGDT (n = 30)	P value
Score	Before therapy
	Mean ± SD.	25.6 ± 3.5	25.4 ± 3.7	25.5 ± 3.7	–
	Median (Min. – Max.)	25.5(19–32)	25.5(19–32)	25.5(20–32)
	After therapy				p1 = 0.900, p2 = 0.041* p3 = 0.013*
	Mean ± SD.	20.8 ± 4.7	20.3 ± 4.6	23.8 ± 4.8
	Median (Min. – Max.)	20.5(12–30)	20(12–30)	25(15–30)
	p0	<0.001*	<0.001*	<0.001*
Lactate	Before therapy				–
	Mean ± SD.	3.0 ± 0.7	2.7 ± 0.5	2.7 ± 0.5
	Median (Min. – Max.)	3(1.7–4.1)	2.8(2–3.8)	2.8(2–4)
	After therapy				p1 = 0.856, p2 = 0.006* p3 = 0.025*
	Mean ± SD.	2.0 ± 0.5	2.1 ± 0.5	2.5 ± 0.6
	Median (Min.–Max.)	2(1–3)	2(1.3–2.9)	2.5(1.1 ± 4.0)
	p0	<0.001*	<0.001*	<0.001*
HR	Before therapy
	Mean ± SD.	100.5 ± 12.8	102 ± 11.8	104.4 ± 12.5	–
	Median (Min – Max.)	98(77–122)	100(79–126)	102.5(84–125)
	After therapy				p1 = 0.827, p2 = 0.028* p3 = 0.005*
	Mean ± SD.	92.8 ± 8.8	91.1 ± 9.2	100.0 ± 13.6
	Median (Min. – Max.)	93.5(75–110)	90(75–112)	96.5(80–122)
	p0	<0.001*	<0.001*	0.001*
MAP	Before therapy				^–
	Mean ± SD.	63.8 ± 4.0	61.9 ± 3.9	62.1 ± 4.8
	Median (Min. – Max.)	64(55.0–74.1)	62(54–68.0)	63(55–70)
	After therapy				p1 = 0.976, p2 < 0.001* p3 < 0.001*
	Mean ± SD.	85.3 ± 3.6	85.1 ± 3.8	73.7 ± 4.9
	Median (Min. – Max.)	85.4(79–92.1)	84.1(79.8–92)	73(65–85)
	p0	<0.001*	<0.001*	<0.001*
CVP	Before therapy				–
	Mean ± SD.	7.8 ± 1.6	8.4 ± 1.0	7.8 ± 1.2
	Median (Min.Max.)	8(5–10)	8.5(7–10)	7.4(6–10)
	After therapy				p1 = 0.207, p2 = 0.022* p3 < 0.001*
	Mean ± SD.	12.1 ± 1.2	11.5 ± 1.6	13.1 ± 1.2
	Median (Min. – Max.)	12.2(8–14.1)	11.4(9–14.5)	12.8(11.2–15.3)
	p0	<0.001*	<0.001*	<0.001*
SPO2	Before therapy
	Mean ± SD.	90.4 ± 4.2	89.5 ± 3.2	89.5 ± 3.4	–
	Median (Min. – Max.)	89(84–98)	90(84–95)	90(84–95)
	After therapy				p1 = 0.977, p2 < 0.001* p3 = 0.001*
	Mean ± SD.	94.2 ± 2.9	94 ± 2.7	90.9 ± 3.7
	Median (Min. – Max.)	93.5(90–99)	95(85–98)	91(84–96)
	p0	<0.001*	<0.001*	0.014*

^{*denote significant, p: p value for comparing between the studied groups, p0: p value for comparing between before and after therapy, p1: p value for comparing between cardiometry and Echo, p2: p value for comparing between cardiometry and EGDT, p3: p value for comparing between Echo and EGDT.}