• Saraschandra Vallabhajosyula, Jeffrey B Geske, Mukesh Kumar, Rahul Kashyap, Kianoush Kashani, and Jacob C Jentzer.
• Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, United States; Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC) Laboratory, Mayo Clinic, Rochester, MN, United States; Center for Clinical and Translational Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN, United States. Electronic address: Vallabhajosyula.Saraschandra@mayo.edu.
• J Crit Care. 2019 Apr 1; 50: 201-206.

BackgroundThe association of pulmonary hypertension (PH) in patients with sepsis is lesser understood.MethodsThis was a retrospective study of adult patients admitted to the intensive care unit during 2007-2014 for sepsis and septic shock, with echocardiography performed <72 h. PH was defined as tricuspid regurgitation peak velocity (TRV) > 3 m/s on Doppler echocardiography. Patients with prior PH, pulmonary stenosis, or without measurable TRV were excluded. Outcomes included 28-day mortality, one-year survival and length of stay.ResultsEighty-three, of 241 (34.4%) patients included, had PH. Patients with PH were older and had greater cardiovascular comorbidity but similar illness severity, including acute respiratory distress syndrome and mechanical ventilation use. PH was an independent predictor of 28-day mortality (odds ratio 3.6 [95% confidence interval 1.1-12.5] p = .04). In a proportional hazards model, PH was an independent predictor of one-year survival (hazard ratio 1.7 [95% confidence interval 1.1-2.7]; p = .03). Severity of PH was associated with worse one-year survival but not 28-day mortality.ConclusionsIn patients with sepsis and septic shock, PH is common and is noted to be associated with higher short and long-term mortality. Further studies are needed to understand the mechanisms by which PH is associated with outcomes.Copyright © 2018 Elsevier Inc. All rights reserved.

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