Document Detail

Right ventricular dysfunction in patients with septic shock.
MedLine Citation:
PMID:  3403793     Owner:  NLM     Status:  MEDLINE    
Using a rapid computerized thermodilution method, we examined the evolution of right ventricular performance in 23 patients with septic shock. Nine survived the episode of septic shock. The other 14 patients died of refractory circulatory shock. Significant right ventricular systolic dysfunction, defined as decreased ejection fraction (-39%) and right ventricular dilation (+38%) was observed in all patients with septic shock. However, in the survivors, increased right ventricular preload may prevent hemodynamic evidence of right ventricular pump failure by utilizing the Frank-Starling mechanism to maintain stroke volume. Conversely, in the nonsurvivors, right ventricular dysfunction was more prononced two days after the onset of septic shock, leading to a fall in stroke. In the last patients, a decrease in contractility appears to be the major factor accounting for decreased right ventricular performance, as evidenced by the marked increase in end-systolic volume (+27%) without significant change in pulmonary artery pressure, during the later stage of septic shock. The observed right ventricular pump failure then appears associated with an alteration in diastolic mechanical properties of this ventricle, as suggested by a leftward displacement of the individual pressure-volume curves.
J F Dhainaut; J J Lanore; J M de Gournay; M F Huyghebaert; F Brunet; D Villemant; J F Monsallier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Intensive care medicine     Volume:  14 Suppl 2     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  1988  
Date Detail:
Created Date:  1988-09-15     Completed Date:  1988-09-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  488-91     Citation Subset:  IM    
Medical ICU, Cochin Port-Royal University Hospital, Paris, France.
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MeSH Terms
Blood Pressure
Cardiac Output
Heart / physiopathology*
Heart Ventricles / physiopathology
Middle Aged
Pulmonary Artery / physiopathology
Shock, Septic / physiopathology*
Stroke Volume*
Thermodilution / methods

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