Sepsis and Tachycardia: Etiologic Factors and Effects on Prognosis

Background: Patients with sepsis predispose cardiac arrhythmias because of excessive inflammation and circulating stress hormones. The present study aimed to identify etiologic factors of tachycardia in critically ill patients with sepsis. We also investigated effects of tachycardia on prognosis. Methods: A prospective observational study was conducted in adult patients who were diagnosed with sepsis and followed over than 48 hours in intensive care unit. Demographic data, comorbid diseases, and clinical and laboratory data were collected prospectively. Patients were followed up until death or hospital discharge. Early goal-directed therapy used to achieve hemodynamic optimization. Results: We observed tachycardia in all patients during follow up. The time of heart rate greater than 100 bpm was 34.6±39.7 (%95 CI 23.3-45.9). There was correlation between tachycardia and pH, mean arterial pressure (MAP), base excess, temperature, and procalcitonin level (p<0.05). When these factors were analyzed with linear regression, it was found that MAP, temperature, and procalcitonin levels were associated with increased heart rate (p<0.05). Conclusion: We identified that low mean arterial pressure, high body temperature and high procalcitonin levels were important factors in tachycardia etiology. According to our findings, there may be also a relationship between inflammation and tachycardia. This study also showed that duration of tachycardia may be related with mortality.