TAILIEUCHUNG - Vieillard-Baron Annals of Intensive Care 2011, 1:6

Vieillard-Baron Annals of Intensive Care 2011, 1:6 REVIEW Open Access Septic cardiomyopathy Antoine Vieillard-Baron1,2 Abstract Depression of left ventricular (LV) intrinsic contractility is constant in patients with septic shock. Because most parameters of cardiac function are strongly dependent on afterload, especially in this context, the cardiac performance evaluated at the bedside reflects intrinsic contractility, but also the degree of vasoplegia. Recent advances in echocardiography have allowed better characterization of septic cardiomyopathy. It is always reversible providing the patient’s recovery. Unlike classic cardiomyopathy, it is not associated with high filling pressures, for two reasons: improvement in LV compliance and associated right ventricular dysfunction. Although, it. | Vieillard-Baron Annals of Intensive Care 2011 1 6 http content 1 1 6 Ù Annals of Intensive Care a SpringerOpen Journal REVIEW Open Access Septic cardiomyopathy Antoine Vieillard-Baron1 2 Abstract Depression of left ventricular LV intrinsic contractility is constant in patients with septic shock. Because most parameters of cardiac function are strongly dependent on afterload especially in this context the cardiac performance evaluated at the bedside reflects intrinsic contractility but also the degree of vasoplegia. Recent advances in echocardiography have allowed better characterization of septic cardiomyopathy. It is always reversible providing the patient s recovery. Unlike classic cardiomyopathy it is not associated with high filling pressures for two reasons improvement in LV compliance and associated right ventricular dysfunction. Although it is unclear to which extent it affects prognosis a hyperkinetic state is indicative of a profound and persistent vasoplegia associated with a high mortality rate. Preliminary data suggest that the hemodynamic response to a dobutamine challenge has a prognostic value but large studies are required to establish whether inotropic drugs should be used to treat this septic cardiac dysfunction. Introduction Reversible myocardial depression in patients with septic shock was first described in 1984 by Parker et al. using radionuclide cineangiography 1 . In a series of 20 patients they reported a 65 incidence of left ventricular LV systolic dysfunction defined by an ejection fraction 45 1 . In 1990 using transthoracic echocardiography Jardin et al. reported the same results 2 . In a canine model simulating human septic shock Natanson et al. demonstrated that intrinsic LV performance was actually depressed in all animals and not corrected by volume expansion 3 . Finally more recently Barraud et al. confirmed the presence of severe depressed intrinsic LV contractility using LV pressure volume loops in .

TÀI LIỆU LIÊN QUAN
TAILIEUCHUNG - Chia sẻ tài liệu không giới hạn
Địa chỉ : 444 Hoang Hoa Tham, Hanoi, Viet Nam
Website : tailieuchung.com
Email : tailieuchung20@gmail.com
Tailieuchung.com là thư viện tài liệu trực tuyến, nơi chia sẽ trao đổi hàng triệu tài liệu như luận văn đồ án, sách, giáo trình, đề thi.
Chúng tôi không chịu trách nhiệm liên quan đến các vấn đề bản quyền nội dung tài liệu được thành viên tự nguyện đăng tải lên, nếu phát hiện thấy tài liệu xấu hoặc tài liệu có bản quyền xin hãy email cho chúng tôi.
Đã phát hiện trình chặn quảng cáo AdBlock
Trang web này phụ thuộc vào doanh thu từ số lần hiển thị quảng cáo để tồn tại. Vui lòng tắt trình chặn quảng cáo của bạn hoặc tạm dừng tính năng chặn quảng cáo cho trang web này.