Evidence map›Paper›PMID 39419883›Full record

SynthesisJournal of ultrasound2025

The association between integrating echocardiography use in the management of septic shock patients and outcomes in the intensive care unit: a systematic review and meta-analysis.

Keith Killu, Cecilia Patino-Sutton, Lynn Kysh, Richard Castriotta, John Oropello, Luis Huerta, Dominic Engracia, Karim Merchant, Choo Phei Wee, Victoria Kristence Cortessis

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of ultrasound, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Keith KilluKeck School of Medicine, Pulmonary Critical Care and Sleep Division, Department of Internal Medicine, University of Southern California, 2020 Zonal Ave., IRD #720, Los Angeles, CA, 90033, USA. keith.killu@med.usc.edu.ORCID http://orcid.org/0000-0002-3314-0195
Cecilia Patino-SuttonKeck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
Lynn KyshKeck School of Medicine, Norris Medical Library, University of Southern California, Los Angeles, CA, USA.
Richard CastriottaKeck School of Medicine, Pulmonary Critical Care and Sleep Division, Department of Internal Medicine, University of Southern California, 2020 Zonal Ave., IRD #720, Los Angeles, CA, 90033, USA.
John OropelloThe Ichan School of Medicine at the Mount Sinai Hospital, New York, NY, USA.
Luis HuertaKeck School of Medicine, Pulmonary Critical Care and Sleep Division, Department of Internal Medicine, University of Southern California, 2020 Zonal Ave., IRD #720, Los Angeles, CA, 90033, USA.
Dominic EngraciaKeck School of Medicine, Pulmonary Critical Care and Sleep Division, Department of Internal Medicine, University of Southern California, 2020 Zonal Ave., IRD #720, Los Angeles, CA, 90033, USA.
Karim MerchantKeck School of Medicine, Pulmonary Critical Care and Sleep Division, Department of Internal Medicine, University of Southern California, 2020 Zonal Ave., IRD #720, Los Angeles, CA, 90033, USA.
Choo Phei WeeKeck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.
Victoria Kristence CortessisKeck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA.

Funding

Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
NCATS NIH HHS UL1 TR001855NCATS NIH HHS UL1TR001855
6 · The paper itself

Abstract

objectivesSeptic shock in critically ill patients can increases morbidity and mortality. We aimed to study the effect on outcomes when integrating point of care (POC) echocardiography in the management of septic shock patients in the Intensive Care Unit (ICU) who are being treated according to the Surviving Sepsis Campaign (SSC) guidelines.

methodsAn electronic search of MEDLINE through PubMed, clinical trials.gov and google scholar was conducted for the period from January 1990-January 2024 to identify studies of septic shock adult and pediatric patients in the ICU managed according to SSC guidelines with or without POC echocardiography. Three reviewers extracted data independent of each other. Cochrane collaboration tool was used for bias assessment. Random effect meta-analysis used to pool data.

resultsA total of 1701 articles identified. Seven studies included in the final report with a total of 3885 patients. POC echocardiography guided septic shock management was associated with lower in-hospital and 28-day mortality (sOR = 0.82 [95%CI: 0.71-0.95], p = 0.01), more frequent initiation of inotropic support (sOR = 2.42 [95%CI 1.92-3.03], p < 0.0001) and shorter time to achieve lactate clearance (SMD = - 0.87 h [95%CI - 1.23 h to - 0.51 h], p < 0.0001). Summary estimates did not achieve significance for effect of POC echocardiography on 24-h fluid intake (SMD = - 2.11 ml [95%CI - 5.93 ml to 1.72 ml], p = 0.28) on mechanical ventilation-free days (SMD = 0.03 days [95%CI - 0.04 to 0.10], p = 0.94). Shock reversal time analysis was less meaningful due to the small number of studies reporting outcome.

conclusionsPOC echocardiography guided management in septic shock patients in the ICU can lead to a decrease in mortality, increase in initiation of inotropic support, and a decrease in lactate clearance time. Larger cohort studies and data collection and analysis are needed for further understanding and optimizing standardization of protocols for POC echocardiography use in septic shock patients in the ICU.

Indexed as

EchocardiographyIntensive Care UnitsPoint-of-Care SystemsShock, SepticHospital MortalityHumansEchocardiographyInotropic supportMortalityPoint of careSeptic shockUltrasound

Identifiers

PMID39419883
PMCPMC12145375

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.