Objective To investigate the predictive value of quantitative parameters of contrast-enhanced ultrasound (CEUS) for organ dysfunction in patients with sepsis. Methods Fifty-one patients with sepsis admitted to the Department of Critical Care Medicine of Renmin Hospital of Wuhan University from August 2021 to April 2022 were enrolled. At the same time

10 non-septic shock patients were selected as the control group. Renal perfusion was quantified by contrast-enhanced ultrasound within 24 hours after admission. Sepsis patients were divided into two groups according to SOFA score: severe organ failure group with SOFA > 6 and non-severe group with SOFA≤6 within 24 hours after admission to ICU. Patients with increased SOFA score (ΔSOFA score ≥1) within 24 to 48 hours after ICU admission were defined as organ function deterioration group

and patients with ΔSOFA score < 1 were defined as non-deterioration group. Patients with sepsis were divided into death group and survival group according to the survival after admission to ICU. The changes of conventional circulation and CEUS quantitative parameters were compared between the two groups. Results There were no significant differences in traditional circulatory parameters (HR

SAP

MAP

CVP

EF

RI) between sepsis patients and non-sepsis patients

while Lac

PaO2/FiO2 ratio

SOFA score and quantitative parameters (TTP

AUC

PI) of contrast-enhanced ultrasound were significantly different. There were no significant differences in HR

MAP

EF

PaO2/FiO2

RI between the severe group and the non-severe group

while Lac

AUC

PI were significantly different (p < 0.05). There was no difference in macrocirculation

PaO2/FiO2

Lac and RI between the deterioration group and the non-deterioration group

while AUC and PI were significantly different (p < 0.05). There were no differences in circulatory parameters between the death group and the survival group. The ROC curve of Lac

AUC and PI was drawn to predict severe organ failure

and the area under the curve AUC (0.81) and PI (0.75) were greater than Lac (0.73).Conclusions Quantitative parameters of contrast-enhanced ultrasound can reflect organ dysfunction earlier than traditional circulatory parameters

and have certain predictive value for organ dysfunction. It is expected to become a non-invasive method for assessing microcirculation in patients with sepsis at the bedside.