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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về y học đề tài: Clinical review: Myocardial depression in sepsis and septic shock. | Critical Care December 2002 Vol 6 No 6 Court et al. Review Clinical review Myocardial depression in sepsis and septic shock Olivier Court1 Aseem Kumar2 Joseph E Parrillo3 and Anand Kumar4 1 Fellow Section of Critical Care Medicine Health Sciences Center University of Manitoba Winnipeg Canada 2Assistant Professor of Medicine Section of Critical Care Medicine Rush-Presbyterian-St Luke s Medical Center Chicago IL USA 3Director Division of Cardiovascular Diseases and CCM Cooper Hospital Camden NJ USA 4Assistant Professor of Medicine Section of Critical Care Medicine Health Sciences Center University of Manitoba Winnipeg Canada Correspondence Anand Kumar akumar61@yahoo.com Published online 12 September 2002 Critical Care 2002 6 500-508 DOI 10.1186 cc1822 This article is online at http ccforum.com content 6 6 500 2002 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X Abstract Myocardial dysfunction frequently accompanies severe sepsis and septic shock. Whereas myocardial depression was previously considered a preterminal event it is now clear that cardiac dysfunction as evidenced by biventricular dilatation and reduced ejection fraction is present in most patients with severe sepsis and septic shock. Myocardial depression exists despite a fluid resuscitation-dependent hyperdynamic state that typically persists in septic shock patients until death or recovery. Cardiac function usually recovers within 7-10 days in survivors. Myocardial dysfunction does not appear to be due to myocardial hypoperfusion but due to circulating depressant factors including the cytokines tumor necrosis factor alpha and IL-1p. At a cellular level reduced myocardial contractility seems to be induced by both nitric oxide-dependent and nitric oxide-independent mechanisms. The present paper reviews both the clinical manifestations and the molecular cellular mechanisms of sepsis-induced myocardial depression. Keywords contractility cytokine heart myocardial depression nitric oxide Sepsis .
