Sepsis remains a major cause of morbidity and mortality among critically ill patients. Sepsis-induced cardiac dysfunction is common and associated with poor outcomes, but the prognostic value of specific transthoracic echocardiography (TTE) parameters in this setting is not well established.

This prospective longitudinal study aims to identify echocardiographic parameters that can reliably predict ICU and hospital outcomes in adult patients with sepsis requiring invasive mechanical ventilation. A total of 300 patients aged 18–80 years, diagnosed with sepsis as per Sepsis-3 criteria, will be recruited from intensive care units at Kasturba Medical College Hospitals, Manipal and Mangalore.

TTE will be performed on Day 1 and Day 3 of sepsis diagnosis to assess left and right ventricular function, hemodynamic parameters, and lung/renal ultrasound indices. Clinical data, biomarkers, and outcomes including 28-day in-hospital mortality, ICU mortality, prolonged ICU stay, and hospital readmission within 6 months will be recorded. The study will also characterize echocardiographic and POCUS parameters corresponding to sepsis-induced acute respiratory failure phenotypes (A–D).

The findings are expected to identify specific TTE parameters predictive of adverse outcomes in sepsis, support phenotype-based risk stratification, and contribute to improved prognostication and clinical decision-making in critically ill patients.