Document Detail

Sepsis and the heart.
MedLine Citation:
PMID:  19939836     Owner:  NLM     Status:  MEDLINE    
Septic shock, the most severe complication of sepsis, accounts for approximately 10% of all admissions to intensive care. Our understanding of its complex pathophysiology remains incomplete but clearly involves stimulation of the immune system with subsequent inflammation and microvascular dysfunction. Cardiovascular dysfunction is pronounced and characterized by elements of hypovolaemic, cytotoxic, and distributive shock. In addition, significant myocardial depression is commonly observed. This septic cardiomyopathy is characterized by biventricular impairment of intrinsic myocardial contractility, with a subsequent reduction in left ventricular (LV) ejection fraction and LV stroke work index. This review details the myocardial dysfunction observed in adult septic shock, and discusses the underlying pathophysiology. The utility of using the regulatory protein troponin for the detection of myocardial dysfunction is also considered. Finally, options for the management of sepsis-induced LV hypokinesia are discussed, including the use of levosimendan.
J D Hunter; M Doddi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  104     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-01-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  3-11     Citation Subset:  IM    
Macclesfield District General Hospital, Victoria Road, Macclesfield SK10 3BL, UK.
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MeSH Terms
Biological Markers / blood
Shock, Septic / complications*,  physiopathology
Troponin / blood
Ventricular Dysfunction / diagnosis,  etiology*,  therapy
Reg. No./Substance:
0/Biological Markers; 0/Troponin

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