Effects of Blood Glucose Levels on Liver Functions in Sepsis Patients

Objective To determine the association between the value of early diastolic transmitral velocity to early mitral anulus diastolic velocity ratio （E/E’）measured by bedside ultrasound and pulmonary edema in severe sepsis (including septic shock) patients. Methods Data were obtained from the critical ultrasound database between November 2014 and August 2015. The severe sepsis (including septic shock) patients were eligible, but those with chronic heart disease or acute heart failure were excluded. Pulmonary edema was quantified by lung ultrasound score. The patients were divided into two groups according to lateral E/E’. E/E’-high group was defined as the lateral E/E’＞8, and the others were in E/E’-low group. The severity and distribution of pulmonary edema were compared between the two groups. The correlation analysis and logistic regression analysis were performed to determine whether E/E’ was the independent risk factor of pulmonary edma. Results There were 82 cases included. The lung ultrasound score of E/E’-high group was significantly higher than that of E/E’-low group （ P=0.007）. There was no statistic difference of pulmonary edema severity in the bilateral 5 th and 6 th ultrasound exam areas, but E/E’-high group were more severe in the bilateral 1 th to 4 th ultrasound exam areas （ P=0.004）. Linear-regression analysis demonstrated that E/E’ and inferior vena cava diameter were independent risk factors of pulmonary edema (standardized regression coefficients were 0.425 and 0.249，respectively, P<0.05). Conclusion E/E’ is the independent risk factor of pulmonary edema in severe sepsis and septic shock patients.