To investigate the clinical significance of cardiac function parameters in intensive care unit (ICU) patients with early stage acute cerebral disease.

Seventy-one patients with acute cerebral disease treated in the ICU from January 2009 to December 2014 were retrospective reviewed. All the patients underwent PICCO catherization to monitor hemodynamic parameters, especially cardiac function parameters, within six hours. Information about age, sex, APACHE Ⅱ score, Glasgow coma scale (GCS) score, and outcome at 28 days was collected. The clinical diagnostic data on the type of cerebral disease, hypertension, coronary heart disease, and heart failure were also collected. Cardiac function parameters were measured with PULSION PiCCO plus, including cardiac function index (CFI), global ejection fraction (GEF), left ventricular contractility index (dpmax), and cardiac index (CI). The patients were divided into either a death group or a survival group according to the outcome at 28 days. Then cardiac function parameters were analyzed in the two groups.

There was a significant difference in GCS score between the two groups (P=0.02). There was a higher dpmax level in the death group on the 2nd, 3rd, 4^th, and 7th day after the onset of the disease (P=0.012, 0.016, 0.025, and 0.029, respectively), but there was a lower CI on the 3rd day and SVI level on the 7th day in the death group after the onset of the disease (P=0.013 and 0.015, respectively). Further correlation analysis showed that there were significant correlations between most of the cardiac function parameters measured by PiCCO, though there was no significant correlation between dpmax and GEF (r=0.02, P= 0.75) or SVI (r=-0.02, P=0.622). Except CI (r=-0.07, P=0.133), other cardiac function parameters were all significantly correlated with GCS score. Partial correlation analysis showed that there was no correlation between the cardiac function parameters and the number of days of onset in both the overall patients and the patients in the survival group or the death group. Further survival analysis showed that CFI on the 2nd day, CFI on the 3rd day, dpmax on the 2nd day, dpmax on the 3rd day, and CI on the 1st day had significant effects on 28-day survival (P=0.038, 0.019, 0.035, 0.020, and 0.019, respectively). The survival rate of patients with reduced CFI and CI and patients with normal dpmax decreased significantly.

After the onset of acute cerebral disease, there are cardiac function changes, which is related to the 28-day survival rate.