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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2015

Open Access 01-12-2015 | Research

New-onset supraventricular arrhythmia during septic shock: prevalence, risk factors and prognosis

Authors: Aurélien Seemann, Florence Boissier, Keyvan Razazi, Guillaume Carteaux, Nicolas de Prost, Christian Brun-Buisson, Armand Mekontso Dessap

Published in: Annals of Intensive Care | Issue 1/2015

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Abstract

Background

The aims of this study were to prospectively assess the prevalence of sustained (lasting more than 30 s) new-onset supraventricular arrhythmia (NOSVA) during septic shock, identify the associated factors (including septic myocardial dysfunction), and evaluate its impact on hemodynamics and prognosis.

Methods

Patients with a diagnosis of septic shock were screened in a medical intensive care unit of a tertiary hospital center in France with a continuous 12-lead EKG for the occurrence of NOSVA. Biological and clinical data (including septic myocardial dysfunction characterized by echocardiography) were collected. We also assessed the hemodynamic tolerance and prognosis of NOSVA.

Results

Among the 71 septic shock episodes assessed during the study, NOSVA occurred in 30 [prevalence of 42 %, 95 % confidence interval (CI) 30–53 %]. Among all recorded factors, only renal failure (as assessed by renal SOFA score at day 1) was associated with NOSVA and this difference persisted by multivariable analysis (odds ratio of 1.29, 95 % CI 1.03–1.62, p = 0.03). There was a significant increase in norepinephrine dosage during the first hour after SVA onset. NOSVA was associated with longer catecholamine use during septic shock as compared with patients in sinus rhythm, whereas ICU mortality was identical between groups.

Conclusions

We found a high prevalence of sustained NOSVA during septic shock. NOSVA was not related to septic myocardial dysfunction, but rather to acute renal failure, raising the hypothesis of an acute renocardiac syndrome.
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Metadata
Title
New-onset supraventricular arrhythmia during septic shock: prevalence, risk factors and prognosis
Authors
Aurélien Seemann
Florence Boissier
Keyvan Razazi
Guillaume Carteaux
Nicolas de Prost
Christian Brun-Buisson
Armand Mekontso Dessap
Publication date
01-12-2015
Publisher
Springer Paris
Published in
Annals of Intensive Care / Issue 1/2015
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-015-0069-5

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