| Actual incidence of global left ventricular hypokinesia in adult septic shock. | |
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MedLine Citation:
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PMID: 18496368 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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RATIONALE AND OBJECTIVE: To evaluate the actual incidence of global left ventricular hypokinesia in septic shock. METHOD: All mechanically ventilated patients treated for an episode of septic shock in our unit were studied by transesophageal echocardiography, at least once a day, during the first 3 days of hemodynamic support. In patients who recovered, echocardiography was repeated after weaning from vasoactive agents. Main measurements were obtained from the software of the apparatus. Global left ventricular hypokinesia was defined as a left ventricular ejection fraction of <45%. MEASUREMENTS AND MAIN RESULTS: During a 3-yr period (January 2004 through December 2006), 67 patients free from previous cardiac disease, and who survived for >48 hrs, were repeatedly studied. Global left ventricular hypokinesia was observed in 26 of these 67 patients at admission (primary hypokinesia) and in 14 after 24 or 48 hrs of hemodynamic support by norepinephrine (secondary hypokinesia), leading to an overall hypokinesia rate of 60%. Left ventricular hypokinesia was partially corrected by dobutamine, added to a reduced dosage of norepinephrine, or by epinephrine. This reversible acute left ventricular dysfunction was not associated with a worse prognosis. CONCLUSION: Global left ventricular hypokinesia is very frequent in adult septic shock and could be unmasked, in some patients, by norepinephrine treatment. Left ventricular hypokinesia is usually corrected by addition of an inotropic agent to the hemodynamic support. |
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Authors:
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Antoine Vieillard-Baron; Vincent Caille; Cyril Charron; Guillaume Belliard; Bernard Page; François Jardin |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 36 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-06-03 Completed Date: 2008-06-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1701-6 Citation Subset: AIM; IM |
Affiliation:
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Medical Intensive Care Unit, University Hospital Ambroise Paré, Assistance Publique Hôpitaux de Paris, Boulogne Cedex, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Adult Aged Cardiac Output, Low / drug therapy, epidemiology*, mortality, ultrasonography Cardiotonic Agents / therapeutic use Critical Care* Cross-Sectional Studies Dobutamine / therapeutic use Drug Therapy, Combination Echocardiography, Transesophageal / drug effects Epinephrine / therapeutic use Female Hemodynamics / drug effects Humans Incidence Male Middle Aged Norepinephrine / therapeutic use Prospective Studies Respiration, Artificial Survival Rate Ventricular Dysfunction, Left / drug therapy, epidemiology*, mortality, ultrasonography Ventricular Dysfunction, Right / drug therapy, epidemiology, mortality, ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Cardiotonic Agents; 34368-04-2/Dobutamine; 51-41-2/Norepinephrine; 51-43-4/Epinephrine |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2008 Jun;36(6):1950-1
[PMID:
18520645
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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