Document Detail


Right ventricular dysfunction and dilatation, similar to left ventricular changes, characterize the cardiac depression of septic shock in humans.
MedLine Citation:
PMID:  2295231     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Septic shock in humans is usually characterized by a high cardiac output, a low systemic vascular resistance, reversible depression of left ventricular ejection fraction, and transient left ventricular dilatation. The relationship of left ventricular to right ventricular function in septic shock is poorly understood. To evaluate right ventricular vs left ventricular performance and to evaluate the relation of biventricular performance to survival, we performed serial hemodynamic and radionuclide angiographic studies in 39 patients with septic shock. Right ventricular ejection fraction was calculated using the two regions of interest method. There were 22 survivors and 17 nonsurvivors. Comparing initial with final (after recovery for survivors; within 24 hours of death for nonsurvivors) studies, each survivor's cardiovascular performance returned toward normal, with significant increases in mean arterial pressure, left and right ventricular ejection fraction, and right ventricular stroke work index. Their profiles also demonstrated significant decreases in central venous pressure, pulmonary artery wedge pressure, pulmonary artery mean pressure, and left and right ventricular end-diastolic volume indices. From initial to final study in the nonsurvivors, there was a statistically significant increase in heart rate but no change in any other cardiovascular parameter, indicating a persistence of the initial cardiovascular dysfunction until death. Comparing serial studies, the pattern of change in right vs left ventricular function was very similar (same direction in 82 percent of patients). Thus, myocardial depression in human septic shock affects both ventricles simultaneously with a similar pattern of dysfunction.
Authors:
M M Parker; K E McCarthy; F P Ognibene; J E Parrillo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  97     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1990 Jan 
Date Detail:
Created Date:  1990-02-14     Completed Date:  1990-02-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  126-31     Citation Subset:  AIM; IM    
Affiliation:
Critical Care Medicine Department, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Blood Pressure
Cardiac Volume
Child
Diastole
Female
Heart / physiopathology*,  radionuclide imaging
Heart Rate
Humans
Male
Middle Aged
Pulmonary Artery / physiopathology
Radionuclide Ventriculography
Shock, Septic / physiopathology*,  radionuclide imaging
Stroke Volume
Vascular Resistance

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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