Lack of early left ventricular outflow tract velocity time integral estimated volume responsiveness is associated with increased morbidity and mortality

ABSTRACT

Background: Fluid boluses are amongst the strongest recommendations for the management of septic patients, and they are generally administered with the goal increasing cardiac output and improving tissue perfusion. Early identification of volume responsiveness is challenging and dependent on many patient factors, but it may prevent the harmful consequences of hypervolemia. Left ventricular outflow tract (LVOT) velocity time integral (VTI) has been used as a predictor of volume responsiveness. Study Objectives: The purpose of this study was to determine whether lack of volume responsiveness, defined as =15% change in LVOT VTI, is associated with increased risk of mortality, admission to an intensive care unit (ICU), or rapid response team activation within 24 hours of hospital arrival (composite outcome measure). We hypothesize that septic patients who are not volume responders will be more critically ill and therefore at greater risk of experiencing the composite outcome.