| Early preload adaptation in septic shock? A transesophageal echocardiographic study. | |
| | |
MedLine Citation:
|
PMID: 11374597 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: An accepted concept in septic shock is that preload adaptation by acute left ventricular dilatation, when occurring spontaneously or with the aid of volume loading, permits maintenance of an adequate cardiac output, leading to final recovery. From a physiologic point of view, this concept appears debatable because a normal pericardium exerts a restraining action on a normal heart. METHODS: During a 26-month period, the authors investigated, by transesophageal echocardiography, 40 patients hospitalized in their unit for an episode of septic shock. Transesophageal echocardiography was performed in the first hours after admission, proceeded by correction of any hypovolemia, and stabilization of arterial pressure by vasoactive agent infusion if necessary. Left ventricular dimensions were obtained in long- and short-axis views, permitting calculation of left ventricular ejection fraction (long axis) and fractional area contraction (short axis). Stroke index was simultaneously measured by the Doppler technique. RESULTS: Stroke index was strongly correlated with both echocardiographic left ventricle ejection fraction (r = 0.75; P < 0.0001) and left ventricle fractional area contraction (r = 0.76; P < 0.0001), whereas it was independent of echocardiographic left ventricle diastolic dimensions. CONCLUSIONS: The transesophageal echocardiography study was unable to confirm the reality of the concept of early preload adaptation by left ventricular dilatation in septic shock. Conversely, because left ventricular volume always remained in a normal range after correcting hypovolemia, systolic function was the unique determinant of stroke index in septic shock. |
| | |
Authors:
|
A Vieillard Baron; J M Schmitt; A Beauchet; R Augarde; S Prin; B Page; F Jardin |
Related Documents
:
|
116607 - The effects of intraaortic balloon counterpulsation on myocardial infarct size. 2214737 - Effect of histamine antagonists on myocardial carcinine metabolism during compound 48/8... 11807337 - Spinal cord infarction caused by cardiac tamponade. 1204357 - Changes in the plasma kinin system in patients with myocardial infarction. 7313297 - Estimation of infarct size by determination of myocardial 3h-tetracycline accumulation ... 116607 - The effects of intraaortic balloon counterpulsation on myocardial infarct size. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Anesthesiology Volume: 94 ISSN: 0003-3022 ISO Abbreviation: Anesthesiology Publication Date: 2001 Mar |
Date Detail:
|
Created Date: 2001-05-25 Completed Date: 2001-06-14 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 1300217 Medline TA: Anesthesiology Country: United States |
Other Details:
|
Languages: eng Pagination: 400-6 Citation Subset: AIM; IM |
Affiliation:
|
Medical Intensive Care Unit, University Hospital Ambroise Paré, Boulogne, France. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Echocardiography, Transesophageal* Female Fluid Therapy Hemodynamics* Humans Linear Models Male Middle Aged Respiration, Artificial Shock, Septic / physiopathology*, therapy Sympathomimetics / therapeutic use |
| Chemical | |
Reg. No./Substance:
|
0/Sympathomimetics |
| Comments/Corrections | |
Comment In:
|
Anesthesiology. 2001 Dec;95(6):1535
[PMID:
11767769
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Surgical stimulation shifts EEG concentration-response relationship of desflurane.
Next Document: Nosocomial infections and outcome of critically ill elderly patients after surgery.