RESUMO
OBJECTIVE: To describe the incidence of cardiovascular adverse events in patients with sepsis in its various stages. DESIGN: A longitudinal, descriptive, observational study was carried out. SETTING: Intensive care units of two university hospitals in Bogotá (Colombia). PATIENTS: A number of patients consecutively admitted to the adult ICU with a diagnosis of sepsis, and no evidence of previous ischemic myocardial injury. INTERVENTIONS: Forty-eight hours of electrocardiographic record using Holter technology. MAIN VARIABLES: Ischemia, cardiac arrhythmia, heart rate variability. RESULTS: A total of 100 patients were analyzed, 62% being staged as presenting septic shock. Three percent suffered ischemic events detected by Holter and unnoticed through conventional monitoring. Forty-six percent suffered an arrhythmic event detected by Holter, compared with only 6% as detected by conventional monitoring. Mortality was 40%. All patients showed loss of heart rate variability. CONCLUSION: In this study patients with sepsis showed a low incidence of cardiovascular ischemic events. In contrast, arrhythmic events showed a high incidence. Conventional monitoring failed to detect any of the ischemic events and most arrhythmic events. In this study, cardiovascular events generated by adrenergic discharge had no impact upon mortality.
