Assessing myocardial stunning during continuous renal replacement therapy in critically ill patients

Abstract

Introduction: Myocardial stunning, a temporary reduction in cardiac contractility, is well-recognized in chronic hemodialysis patients but less studied in critically ill patients undergoing continuous renal replacement therapy (CRRT). Methods: A prospective observational 11-month study included 38 intensive care unit (ICU) patients with acute kidney injury at Mohammed V University Hospital. Myocardial stunning was evaluated using echocardiographic parameters such as global longitudinal strain and left ventricular ejection fraction. Results: Myocardial stunning was observed in 60.5% of patients. It was strongly associated with increased vasopressor requirements, longer ICU stays, and higher mortality (47.8% vs. 6.7%). Conclusion: The high incidence of myocardial stunning in critically ill patients undergoing CRRT highlights the need for vigilant cardiac monitoring and targeted interventions to improve patient outcomes.