Hubungan antara Eccentricity Index (EI) dan Stroke Volume Variation (SVV) dalam Menilai Status Volume Cairan pada Pasien Sepsis di Ruang Rawat Intensif Rumah Sakit Adam Malik Medan

Abstract

Background: Fluid overload (FO) remains a major challenge in fluid therapy for septic patients in the ICU, associated with higher morbidity and mortality. Non- invasive parameters such as Stroke Volume Variation (SVV) help assess fluid status, while the Eccentricity Index (EI) reflects overload effects on the right ventricle through interventricular septal changes. Methods: This cross-sectional observational study included newly diagnosed septic patients admitted to the ICU of Adam Malik Hospital Medan after fluid resuscitation based on the 2021 Surviving Sepsis Campaign guidelines. FO assessment was performed within the first 24 hours using SVV (USCOM) and EI (echocardiography). Results: Among 29 patients, 55.2% were male, with a mean age of 47.17 ± 12.25 years and BMI of 24.21 ± 2.34 kg/m2. Respiratory tract infection was the leading cause of sepsis (65.5%). Mean hemodynamic parameters were: systolic blood pressure 129.41 ± 15.43 mmHg, diastolic blood pressure 75.34 ± 11.45 mmHg, mean arterial pressure 93.37 ± 11.41 mmHg, and heart rate 89.14 ± 12.74 bpm. A strong negative correlation was observed between EI and SVV (r = –0.802; p < 0.05). Significant differences in EI and SVV values were found between septic patients with FO and those without FO (p < 0.05). Conclusion: EI can serve as an alternative to SVV in evaluating FO among septic patients in the ICU, as it reflects morphological changes in cardiac chambers and the interventricular septum. Keywords: eccentricity index, fluid overload, intensive care unit, sepsis, stroke volume variatio