March 8, 2017

Dr. Ehrman secures grant to study sepsis-cardiac dysfunction relationship

A Wayne State University School of Medicine Emergency Medicine physician has secured a grant from the Society for Academic Emergency Medicine Foundation to examine cardiac function in patients with sepsis admitted through emergency rooms with the aim of establishing individualized resuscitation strategies to improve patient outcomes.

Robert Ehrman, M.D., assistant professor of Emergency Medicine for the Wayne State University School of Medicine and assistant director of Emergency Ultrasound at Sinai-Grace Hospital, will use the $150,000 grant to study the relationship between sepsis and cardiac function in the emergency room before the patient has been resuscitated and moved to an intensive care unit.

Sepsis is the body's response to serious infection, and can lead to organ failure and death.

"It is well established that patients with sepsis have varying degrees of cardiac dysfunction, but there is conflicting evidence on if and how this affects patient outcomes," Dr. Ehrman said. "Prior studies investigating these associations have all been performed in intensive care units, not the emergency department, and by the time patients arrive in the ICU a great deal of resuscitation has already taken place. The goal of this study is to investigate the relationship between cardiac function at presentation to the emergency department, the treatment patients receive - particularly the volume of intravenous fluids received - and patient outcomes."

Patients who participate in the study, "Is Diastolic Dysfunction Associated with Poor Outcomes in Sepsis?" will be enrolled through Detroit Receiving Hospital and Sinai-Grace Hospital.

Dr. Ehrman said he hopes the improved understanding of cardiac performance during the first 24 hours of treatment for sepsis will allow for more individualized resuscitation strategies, and thus improve patient outcomes and overall sepsis care.

The study will assess the strength of the correlation between diastolic function - the normal beating of the heart - and sepsis severity within the first 24 hours of admission. He hypothesizes that diastolic dysfunction will be more strongly correlated with more severe disease. The study will also explore the relationship between diastolic function at presentation, its change during resuscitation, the total volume of intravenous fluid a patient receives and in-hospital and 28-day mortality. Dr. Ehrman proposes that larger volumes of IV fluid administered to patients with abnormal diastolic function at presentation will lead to a progressive decline in diastolic function during hospitalization, and will be associated with increased in-hospital and 28-day mortality.