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{
    "pk": 13188,
    "title": "Tricuspid Annular Plane of Systolic Excursion for the Evaluation of Patients with Severe Sepsis and Septic Shock",
    "subtitle": null,
    "abstract": "Introduction: \nSepsis is a systemic infection that can rapidly progress into multi organ failure and shock if left untreated. Previous studies have demonstrated the utility of point of care ultrasound (POCUS) in the evaluation of patients with sepsis. However, limited data exists on the evaluation of the tricuspid annular plane of systolic excursion (TAPSE) in patients with sepsis.\nMethods:\n We prospectively enrolled patients who presented to the emergency department (ED) with concern for severe sepsis or septic shock in a pilot study. In patients that screened positive, the treating physician then performed POCUS to measure the TAPSE value. We compared the intensive care unit (ICU) admission rate, hospital length of stay, and morbidity with their respective TAPSE values.\nResults:\n We enrolled 24 patients in the study. Eight patients had TAPSE values less than 16 millimeters (mm), two patients had TAPSE values between 16mm-20mm, and fourteen patients had TAPSE values greater than 20mm. There was no statistically significant association between TAPSE levels and ICU admission (p=0.16), or death (p=0.14). The difference of length of stay (LOS) was not statistically significant in case of hospital LOS (p= 0.72) or ICU LOS.\nConclusion: \nOur pilot data did not demonstrate a correlation between severe sepsis or septic shock and TAPSE values. This may be due to several factors including patient comorbidities, strict definitions of sepsis and septic shock, as well as the absence of septic cardiomyopathy (SCM) in patients with sepsis and septic shock. Future large-scale studies are needed to determine if TAPSE can be beneficial in the ED evaluation of patients with concern for SCM.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Point of care ultrasound, Sepsis, Septic Cardiomyopathy"
        }
    ],
    "section": "Technology in Emergency Care",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/1rw7258p",
    "frozenauthors": [
        {
            "first_name": "Shadi",
            "middle_name": "",
            "last_name": "Lahham",
            "name_suffix": "",
            "institution": "University of California, Irvine; Department of Emergency Medicine, Orange, California",
            "department": "None"
        },
        {
            "first_name": "Clifton",
            "middle_name": "",
            "last_name": "Lee",
            "name_suffix": "",
            "institution": "University of California, Irvine; Department of Emergency Medicine, Orange, California",
            "department": "None"
        },
        {
            "first_name": "Qumber",
            "middle_name": "",
            "last_name": "Ali",
            "name_suffix": "",
            "institution": "University of California, Irvine; Department of Emergency Medicine, Orange, California",
            "department": "None"
        },
        {
            "first_name": "John",
            "middle_name": "",
            "last_name": "Moeller",
            "name_suffix": "",
            "institution": "University of California, Irvine; Department of Emergency Medicine, Orange, California",
            "department": "None"
        },
        {
            "first_name": "Chanel",
            "middle_name": "",
            "last_name": "Fischetti",
            "name_suffix": "",
            "institution": "University of California, Irvine; Department of Emergency Medicine, Orange, California",
            "department": "None"
        },
        {
            "first_name": "Maxwell",
            "middle_name": "",
            "last_name": "Thompson",
            "name_suffix": "",
            "institution": "University of Alabama, Department of Emergency Medicine, Birmingham, Alabama",
            "department": "None"
        },
        {
            "first_name": "Soheil",
            "middle_name": "",
            "last_name": "Saadat",
            "name_suffix": "",
            "institution": "University of California, Irvine; Department of Emergency Medicine, Orange, California",
            "department": "None"
        },
        {
            "first_name": "John",
            "middle_name": "C.",
            "last_name": "Fox",
            "name_suffix": "",
            "institution": "University of California, Irvine; Department of Emergency Medicine, Orange, California",
            "department": "None"
        }
    ],
    "date_submitted": "2019-08-26T05:03:26Z",
    "date_accepted": "2019-08-26T05:03:26Z",
    "date_published": "2020-01-13T20:56:29Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13188/galley/6933/download/"
        }
    ]
}