Sepsis and tachycardia: Etiologic factors and effects on prognosis Purpose: The present study aimed to identify etiologic factors of tachycardia in critically ill patients with sepsis. We also investigated effects of tachycardia on prognosis. Materials and Methods: Following the approval of the Marmara University School of Medicine Ethic Committee and written informed consent of patients’ relatives, a prospective observational study was conducted in adult patients who were diagnosed with sepsis (according to American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee) and followed over than 48 hours in intensive care unit. Exclusion criterias were pregnancy, severe valvular diseases and coronary artery disease, extracorporeal membrane oxygenation usage and patients who does not need mechanical ventilatory support. Demographic data, comorbid diseases, and clinical and laboratory data were collected prospectively. Patients were followed up until death or hospital discharge. Early goal-directed therapy used to achieve hemodynamic optimization. Results: Thirty men and twenty women, a total of 50 patients were included to study. We observed tachycardia in all patients during follow up. The time of heart rate greater than 100 bpm was 34.6±39.7 (%95 CI 23.3-45.9). There was correlation between tachycardia and pH, mean arterial pressure (MAP), base excess, temperature, and procalcitonin level (p<0.05). When these factors were analyzed with linear regression, it was found that MAP, temperature, and procalcitonin levels were associated with increased heart rate (p<0.05). Eighteen patients were discharged from intensive care unit and 32 patients died. Duration of tachycardia, APACHE and SOFA scores were associated with mortality. Conclusions: We observed that tachycardia incidence is high in patients with sepsis. We identified that MAP, body temperature and procalcitonin levels were associated with tachycardia. This finding supports, the role of inflammation in tachycardia. Additionally, our data support that duration of tachycardia might be relevant with mortality.
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