Document Detail


Right ventricular function of patients with septic shock: clinical significance.
MedLine Citation:
PMID:  11832088     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To understand the effect of right ventricular dysfunction on circulatory supportive therapy in patients with septic shock. METHODS: 25 patients with septic shock who were admitted consecutively to the intensive care unit (ICU) of Peking Union Medical College Hospital were observed prospectively. Hemodynamic profile of the left side and right side heart was monitored with right ventricular ejection fraction catheter and transthoracic echocardiography. Intramucosal pH (pHi) and oxygen delivery were also monitored to illustrate any relation with patient outcome. RESULTS: Stroke volume index (SVI) and right ventricular ejection fraction (RVEF) were significantly higher in survivors than in nonsurvivors (P < 0.01 and < 0.05, respectively). The pulmonary vascular resistance index (PVRI) was significantly lower in survivors (P < 0.01). At the onset of shock, the left ventricular end-diastolic volume index (LVEDVI) of both groups was very low, and steadily increased in survivors but not in nonsurvivors. Left ventricular ejection fraction (LVEF) and systemic vascular resistance index (SVRI) decreased during treatment, which were not different in both groups. Right ventricular end-diastolic volume index (RVEDVI) increased in both survivors and nonsurvivors. Oxygen delivery of nonsurvivors was significantly lower than that of survivors. LVEDVI and RVEF were correlated with SVI in both survivors and nonsurvivors. CONCLUSIONS: The impairment of right heart function may be more severe than that of left heart function in the patients with early septic shock. "Right heart priority" must be seriously considered in supportive treatment of patients with septic shock. The present treatment of septic shock has significant limitations, and even aggravates the existing cardiac dysfunction.
Authors:
D Liu; B Du; Y Long; C Zhao; B Hou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Zhonghua wai ke za zhi [Chinese journal of surgery]     Volume:  38     ISSN:  0529-5815     ISO Abbreviation:  Zhonghua Wai Ke Za Zhi     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2002-02-08     Completed Date:  2005-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0153611     Medline TA:  Zhonghua Wai Ke Za Zhi     Country:  China    
Other Details:
Languages:  eng     Pagination:  488-92     Citation Subset:  IM    
Affiliation:
Department of Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Female
Humans
Male
Middle Aged
Shock, Septic / physiopathology*,  therapy
Stroke Volume
Ventricular Function, Left / physiology
Ventricular Function, Right / physiology*

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