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BMC Anesthesiology
Published in: BMC Anesthesiology 1/2017

Open Access 01-12-2017 | Research article

Systolic blood pressure variability in patients with early severe sepsis or septic shock: a prospective cohort study

Authors: Yi Tang, Jeff Sorenson, Michael Lanspa, Colin K. Grissom, V.J. Mathews, Samuel M. Brown

Published in: BMC Anesthesiology | Issue 1/2017

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Abstract

Background

Severe sepsis and septic shock are often lethal syndromes, in which the autonomic nervous system may fail to maintain adequate blood pressure. Heart rate variability has been associated with outcomes in sepsis. Whether systolic blood pressure (SBP) variability is associated with clinical outcomes in septic patients is unknown. The propose of this study is to determine whether variability in SBP correlates with vasopressor independence and mortality among septic patients.

Methods

We prospectively studied patients with severe sepsis or septic shock, admitted to an intensive care unit (ICU) with an arterial catheter. We analyzed SBP variability on the first 5-min window immediately following ICU admission. We performed principal component analysis of multidimensional complexity, and used the first principal component (PC1) as input for Firth logistic regression, controlling for mean systolic pressure (SBP) in the primary analyses, and Acute Physiology and Chronic Health Evaluation (APACHE) II score or NEE dose in the ancillary analyses. Prespecified outcomes were vasopressor independence at 24 h (primary), and 28-day mortality (secondary).

Results

We studied 51 patients, 51% of whom achieved vasopressor independence at 24 h. Ten percent died at 28 days. PC1 represented 26% of the variance in complexity measures. PC1 was not associated with vasopressor independence on Firth logistic regression (OR 1.04; 95% CI: 0.93–1.16; p = 0.54), but was associated with 28-day mortality (OR 1.16, 95% CI: 1.01–1.35, p = 0.040).

Conclusions

Early SBP variability appears to be associated with 28-day mortality in patients with severe sepsis and septic shock.
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Metadata
Title
Systolic blood pressure variability in patients with early severe sepsis or septic shock: a prospective cohort study
Authors
Yi Tang
Jeff Sorenson
Michael Lanspa
Colin K. Grissom
V.J. Mathews
Samuel M. Brown
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2017
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-017-0377-4

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