Utilization of echocardiography during septic shock was associated with a decreased 28-day mortality: a propensity score-matched analysis of the MIMIC-III database

Septic shock is one of the leading causes of death in critically ill patients, with mortality rates of approximately 40–50% (1-3). It is generally acknowledged that hemodynamic management is of paramount importance in patients with septic shock so as to guarantee organ perfusion and facilitate further titrate therapies (4). Although there are some ways to assess volume status and cardiac function in septic shock, few have been confirmed to actually improve patients’ outcomes. Moreover, the commonly clinically used central venous pressure (CVP) has been shown to be poorly correlated with volume status or fluid responsiveness (5). Pulse index continuous cardiac output (PiCCO) and pulmonary artery catheter (PAC) are two invasive monitors that evaluate both preload and myocardial contractibility and help to guide therapy adjustment. However, PiCCO-based fluid management does not improve outcomes when compared to CVP-based fluid management (6). Likewise, PAC has been used less and less, as there has been no benefit from its use (7), and it has even been associated with an increase in mortality (8)