The Role of Noninvasive Hemodynamic Monitoring in the Early Evaluation of Patients Affected by Sepsis and Septic Shock in the Emergency Department.

Septic patients admitted to the Emergency Department of a teaching hospital, underwent noninvasive continuous monitoring through Nexfin®, which allows to derive patients hemodynamic profile.Of 80 patients included in the study,48 died (60%). Survivors showed higher mean values of stroke volume ( P= 0,001 ), cardiac output ( P=0,005 ) , cardiac index ( P= 0,004 ) and left ventricle contractility index ( P=0,002 ) than nonsurvivors.In the same subjects also the BMI was higher than in nonsurvivors ( P=0,014 ), as well as the lactate levels ( P= 0,029 ). Analysis of each of these variablesshowed a positive correlation with survival. Considering the relation between all the abovementioned variables taken together and the risk of death it is evident that a dP/dTmax and a BMI lower than the median value increase the death risk.The noninvasive hemodynamic monitoring has shown to be useful in the early stratification ofpatients with sepsis and septic shock in Emergency Department.