Effect of myocardial preservation of early goal-directed therapy on severe sepsis/septic shock patients in the ICU

Abstract

Introduction: To investigate the effect of myocardial preservation of early goal-directed therapy (EGDT) on severe sepsis/septic shock patients in the ICU. Methods: This is a prospective and randomized controlled study, in which the total 158 severe sepsis/septic shock patients from the ICU were randomly assigned into two groups (EGDT group, n = 81 and control group, n = 77). Then the concentration of serum cardiac troponin I (cTnI), high sensitivity C-reactive protein (hs-CRP) and APACHE II score of patients were obtained on the 0, 3rd, 7th, and 14th day after fluid resuscitation therapy. Results: The levels of cTnI were the same between the EGDT and control groups on day 0 (exceeded normal cTnI patients in two groups 0.41 vs 0.42, normal cTnI patients in two groups 0.05 vs 0.04, P >0.05), there was a dramatic decrease in exceeded normal cTnI patients of the EGDT group, in which cTnI returned to normal after EGDT (14th day: exceeded normal cTnI patients in two groups 0.08 vs 0.16, P <0.05); however, only a little difference in normal cTnI patients of the two groups (P >0.05). The level of hs-CRP changed like cTnI (P <0.05), and there was positive correlation between cTnI and hs-CRP on each time (P <0.05); APACHE II scores obviously decrease in the EGDT group (P <0.05). Meanwhile, the EGDT group have an obviously higher 28-day survival rate and longer survival time than that of the control group (74.1% vs 55.8%; 23.5 vs 19.6, P <0.05). Conclusions: EGDT has an effect of myocardial preservation and improves the survival rate for severe sepsis/septic shock patients in the ICU.