Please use this identifier to cite or link to this item: https://doi.org/10.1186/s13054-015-1012-8
Title: Hyperdynamic left ventricular ejection fraction in the intensive care unit
Authors: Paonessa, J.R
Brennan, T
Pimentel, M
Steinhaus, D
Feng, M 
Celi, L.A
Keywords: hypertensive factor
vasoconstrictor agent
adult
age distribution
aged
Article
artificial ventilation
cohort analysis
controlled study
critically ill patient
echocardiography
Elixhauser comorbidity index
female
heart left ventricle ejection fraction
hospital admission
human
hyperdynamic left ventricular ejection fraction
hypertension
intensive care unit
Israel
longitudinal study
major clinical study
male
malignant neoplastic disease
middle aged
mortality
priority journal
prognosis
retrospective study
Sequential Organ Failure Assessment Score
sex difference
age
critical illness
heart left ventricle function
heart stroke volume
hospital mortality
hypertension
intensive care unit
Massachusetts
Neoplasms
pathophysiology
physiology
Age Factors
Aged
Boston
Cohort Studies
Critical Illness
Female
Hospital Mortality
Humans
Hypertension
Intensive Care Units
Longitudinal Studies
Male
Middle Aged
Neoplasms
Retrospective Studies
Sex Factors
Stroke Volume
Vasoconstrictor Agents
Ventricular Dysfunction, Left
Issue Date: 2015
Publisher: BioMed Central Ltd.
Citation: Paonessa, J.R, Brennan, T, Pimentel, M, Steinhaus, D, Feng, M, Celi, L.A (2015). Hyperdynamic left ventricular ejection fraction in the intensive care unit. Critical Care 19 (1) : 288. ScholarBank@NUS Repository. https://doi.org/10.1186/s13054-015-1012-8
Rights: Attribution 4.0 International
Abstract: Introduction: Limited information exists on the etiology, prevalence, and significance of hyperdynamic left ventricular ejection fraction (HDLVEF) in the intensive care unit (ICU). Our aim in the present study was to compare characteristics and outcomes of patients with HDLVEF with those of patients with normal left ventricular ejection fraction in the ICU using a large, public, deidentified critical care database. Methods: We conducted a longitudinal, single-center, retrospective cohort study of adult patients who underwent echocardiography during a medical or surgical ICU admission at the Beth Israel Deaconess Medical Center using the Multiparameter Intelligent Monitoring in Intensive Care II database. The final cohort had 2867 patients, of whom 324 had HDLVEF, defined as an ejection fraction >70 %. Patients with an ejection fraction <55 % were excluded. Results: Compared with critically ill patients with normal left ventricular ejection fraction, the finding of HDLVEF in critically ill patients was associated with female sex, increased age, and the diagnoses of hypertension and cancer. Patients with HDLVEF had increased 28-day mortality compared with those with normal ejection fraction in multivariate logistic regression analysis adjusted for age, sex, Sequential Organ Failure Assessment score, Elixhauser score for comorbidities, vasopressor use, and mechanical ventilation use (odds ratio 1.38, 95 % confidence interval 1.039-1.842, p =0.02). Conclusions: The presence of HDLVEF portended increased 28-day mortality, and may be helpful as a gravity marker for prognosis in patients admitted to the ICU. Further research is warranted to gain a better understanding of how these patients respond to common interventions in the ICU and to determine if pharmacologic modulation of HDLVEF improves outcomes. © 2015 Paonessa et al.
Source Title: Critical Care
URI: https://scholarbank.nus.edu.sg/handle/10635/179651
ISSN: 1364-8535
DOI: 10.1186/s13054-015-1012-8
Rights: Attribution 4.0 International
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