Fluid balance and myocardial function relate to mortality of patients with septic shock

Objective To evaluate the correlation between fluid balance and myocardial function and the mortality in patients with septic shock. Methods Ninety two septic shock patients enrolled between January 2013 and January 2015 were divided into survival group and non-survival group based on 28-day mortality. Fluid balance, haemodynamic parameters and B-type natriuretic peptide (BNP) were collected on days1, 3, 7 after admission. Results Forty four patients survived the crisis while 48 died. The 7 day average fluid balance volume in survival group was lower than those in non-survival group [(55±9)ml/kg vs. (187±14)ml/kg, t=54.260, P<0.01]. The initial left ventricle ejection fraction (LVEF) in survival group was lower than that in non-survival group [(42%±4%) vs. (54%±6%), t=10.100, P<0.01]. Serum BNP level was significantly lower than those in non-survival group [(267±54) ng/L vs. (681±22) ng/L, t=48.580, P<0.01]. Multivariate logistic regression analysis showed that fluid positive balance, LVEF and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) were the independent predictors for 28 day mortality (P<0.05). Conclusions Fluid balance and myocardial function can serve as risk predictors for septic shock patients. Key words: Shock, septic; Heart failure; Prognosis