Myocardial Depression: Is it Clinically Relevant?

  • Fred Bongard
Chapter

Abstract

Sepsis is the most common cause of death among patients in critical care units. Advances in respiratory support, hemodialysis, and nutrition have improved overall survival. When septic shock intervenes, however, deterioration may be rapid, with survival rates of 50% or less.1.

Keywords

Septic Shock Cardiac Index Pulmonary Artery Pressure Systemic Vascular Resistance Coronary Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Dhainaut JF, Cariou A, Gest V, et al: Cardiac dysfunction in sepsii. In: Fein AM, Abraham EM, Balk RA, et al. (eds) Sepsis and Multiorgan Failure. Baltimore, Willami & Wilkins, 1997; 209–219.Google Scholar
  2. 2.
    Natanson C, Banner RL, Fink MP, et al: Cardiovascular performance with E. coli challenges in a canine model of human sepsis. Am J Physiol 1988; 254: H558–H569.PubMedGoogle Scholar
  3. 3.
    Snell RJ, Parillo WE. Cardiovascular dysfiinction in septic shock. Chest 1991; 99: 1000–1009.PubMedCrossRefGoogle Scholar
  4. 4.
    Braunwald E: Assessment of cardiac function. In: Braunwald E (ed) Heart Disease: A Textbook of Cardiovascular Medicine. Philadelphia, Saunders, 1988; 457.Google Scholar
  5. 5.
    Parker MM, Suffrendini AF, Natanson C, et al: Response of left ventricular function in survivors and nonsurvivors of septic shock. J Crit Care 1989; 4: 19–25.CrossRefGoogle Scholar
  6. 6.
    Natanson C, Danner RL, Fink MP, et al: Cardiovascular performance with E. coli challenges in a canine model of human sepsis. Am J Physiol 1988; 254: H558–H569.PubMedGoogle Scholar
  7. 7.
    Stahl TJ, Alden PB, Ring WS, et al: Sepsis-induced diastolic dysfunction in chronic canine peritonitis. Am J Physiol 1990; 258: H625–H633.PubMedGoogle Scholar
  8. 8.
    Metrangolo L, Fiorillo M, Friedman G, et al: Early hemodynamic course of septic shock. Crit Care Med 1995; 23: 1971–1975.PubMedCrossRefGoogle Scholar
  9. 9.
    Ognibene FP, Parker MM, Natanson C, et al: Depressed left ventricular performance response to volume infusion in patients with sepsis and septic shock. Chest 1988; 93: 903–910.PubMedCrossRefGoogle Scholar
  10. 10.
    Parker MM, McCarthy KE, Ognibene FP, et al: Right ventricular dysfunction and dilation, similar to left ventricular changes, characterize the cardiac depression of septic shock in humans. oChest 1990; 77: 126–131.CrossRefGoogle Scholar
  11. 11.
    Suffrendi AF, From RE, Parker MM, et al: The cardiovascular response of normal humans to the administration of endotoxin. N Engl J Med 1989; 321: 280–286.CrossRefGoogle Scholar
  12. 12.
    Vincent JL, Reuse C, Frank N, et al: Right ventricular dysfunction in septic shock: assessment by measurements of right ventricular ejection fraction using thermodilution techniques. Acta Anaesth Scand 1989; 33: 34–38.PubMedCrossRefGoogle Scholar
  13. 13.
    Schneider AJ, Teule GJJ, Groeneveld ABJ, et al: Biventricular performance during volume loading in patients with early septic shock, with emphasis on the right ventricle: a combined hemodynamic and radionuclide study. Am Heart J 1988; 116: 103–112.PubMedCrossRefGoogle Scholar
  14. 14.
    Adiseshiah M, Baird RJ: Correlation of the changes in diastolic myocardial tissue pressure and regional coronary blood flow in hemorrhagic and endotoxic shock. J Surg Res 1978; 24: 20–26.PubMedCrossRefGoogle Scholar
  15. 15.
    Cunnion RE, Schaer GL, Parker MM, et al: The coronary circulation in human septic shock. Circulation 1986; 73: 637–644.PubMedCrossRefGoogle Scholar
  16. 16.
    Groeneveld ABJ, Van Lambalgen AA, Van den Bos GC, et al: Maldistribution of heterogeneous coronary blood flow during canine endotoxin shock. Cardiovasc Res 1992; 25: 90–88.Google Scholar
  17. 17.
    Shibano T, Vanhoutte PM: Induction of NO production by TNF-α and lipopolysaccharide in porcine coronary arteries without endothelium. Am J Physiol 1993; 264: H403–H407.PubMedGoogle Scholar
  18. 18.
    McDonough, Lanf CH, Spitzer JJ: The effect of hyperdynamic sepsis on myocardial performance. Circ Shock 1985; 15: 247–259.PubMedGoogle Scholar
  19. 19.
    Lefer M: Role of a myocardial depressant factor in the pathogenesis of circulatory shock. Fed Proc 1970; 29: 1836–1847.PubMedGoogle Scholar
  20. 20.
    Parillo JE, Burch C, Shellhammer JH, et al: A circulating myocardial depressant substance in humans with septic shock. J Clin Invest 1985; 76: 1539–1553.CrossRefGoogle Scholar
  21. 21.
    Schuette JM, Burch C, Roach P, et al: Closed loop television tracking or beating heart cells in vitro. Cytometry 1987; 8: 101–103.PubMedCrossRefGoogle Scholar
  22. 22.
    Reilly JM, Cunnion RE, Burch-Whitman C, et al: A circulating myocardial depressant substance is associated with cardiac dysfunction and peripheral hypoperfusion (lactic acidemia) in patients with septic shock. Chest 1989; 95: 1072–1080.PubMedCrossRefGoogle Scholar
  23. 23.
    Leighton TA, Averbook AW, Klein SR, Bongard FS: Time course of cardiopulmonary effects of tumor necrosis factor and endotoxin are similar. Am Surg 1991; 57: 836–842.PubMedGoogle Scholar
  24. 24.
    Kapadia S, Lee J, Torre-Amione G, et al: Tumor necrosis factor-α gene and protein expression in adult feline myocardium after endotoxin administration. J Clin Invest 1995; 96: 1042–1052.PubMedCrossRefGoogle Scholar
  25. 25.
    Waage A, Espevik T: Interleukin-1 potentiates the lethal effect of tumor necrosis factor/cachectin in mice. J Exp Med 1988;167: 1987–1992.PubMedCrossRefGoogle Scholar
  26. 26.
    Vincent JL, Bakker J, Marecaux G, et al: Administration of anti-TNF antibody improves left ventricular function in septic shock patients. Chest 1992; 101: 810–815.PubMedCrossRefGoogle Scholar
  27. 27.
    Grocott-Mason R, Fort S, Lewis M, et al: Myocardial relaxant effect of exogenous nitric oxide in isolated ejecting hearts. Am J Physiol 1994; 266: H1699–H1705.PubMedGoogle Scholar
  28. 28.
    Vincent JL: Cardiovascular alterations in septic shock. J Antimicrobial Chemother 1998; 41: A9–A15.CrossRefGoogle Scholar
  29. 29.
    Vincent JL, Gris P, Coffernils M, et al: Myocardial depression characterizes the fatal course of septic shock. Surgery 1992; 111: 660–667.PubMedGoogle Scholar
  30. 30.
    Pinsky MR, Vincent JL, Deviere J, et al: Serum cytokine levels in human septic shock: relation to multiple-system organ failure and mortality. 1993; 103: 565–575.Google Scholar
  31. 31.
    Wheeler AP, Berbard GR: Treating patients with severe sepsis. N Engl J Med 1999; 340: 207–214.PubMedCrossRefGoogle Scholar
  32. 32.
    Pulmonary artery catheter consensus conference: consensus statement. Crit Care Med 1997; 25: 910-925.Google Scholar
  33. 33.
    Conners AFJr, Speroff T, Dawson NV, et al: The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA 1996; 275: 889–897.Google Scholar
  34. 34.
    Meier-Hellman A, Reinhart K: Recommendations for the treatment of patients with septic shock. Acta Anaesthesiol Scand 1997; 111: 177–180.Google Scholar
  35. 35.
    Vincent JL, Van der Linden P, Domb M, et al: Dopamine compared with dobutamine in experimental shock: relevance to fluid administration. Anesth Analg 187; 66: 565–571.Google Scholar
  36. 36.
    Shoemaker WC, Appel PL, Kram HB: Oxygen transport measurements to evaluate tissue perfusion and titrate therapy; dobutamine and dopamine effects. Crit Care Med 1991; 19: 672–688.PubMedCrossRefGoogle Scholar
  37. 37.
    Lherm T, Troche G, Rossignol M, et al: Renal effects of low dose dopamine in patients with sepsis syndrome or septic shock treated with catecholamines. Intensive Care Med 1997; 23: 31–37.CrossRefGoogle Scholar
  38. 38.
    Giraud GD, MacCannell KL: Decreased nutrient blood flow during dopamine-and epinephrine-induced intestinal vasodilation. J Pharmacol Exp Ther 1984; 230: 214–220.PubMedGoogle Scholar
  39. 39.
    Meier-Hellman A, Bredle DL, Specht M, et al: The effects of low dose dopamine on splanchnic blood flow and oxygen uptake in patients with septic shock. Intensive Care Med 1997; 23: 31–37.CrossRefGoogle Scholar
  40. 40.
    Van der Berghe G, de Zegher F: Anterior pituitary function during critical illness and dopamine treatment. Crit Care Med 1996; 24: 1580–1590PubMedCrossRefGoogle Scholar
  41. 41.
    Astiz ME, Rackow EC: Septic shock. Lancet 1998; 351: 1501–1505.PubMedCrossRefGoogle Scholar
  42. 42.
    Bersten AD, Hersch M, Cheung H, et al: The effect of various sympathomimetics on the regional circulations in hyperdynamic sepsis. Surgery 1992; 112: 549–561.PubMedGoogle Scholar
  43. 43.
    Marik PE, Mohedin M: The contrasting effects of dopamine and norepinephrine used to treat septic shock patients. Crit Care Med 1990; 18: 282–285.CrossRefGoogle Scholar
  44. 44.
    Hannemann L, Reinhart K, Grenzer O, et al: Comparison of dopamine to dobutamine and norepinephrine for oxygen delivery and uptake in septic shock. Crit Care Med 1995; 23: 1962–1970.PubMedCrossRefGoogle Scholar
  45. 45.
    Vincent JL, Roman A, Kahn RJ: Dobutamine administration in septic shock: addition to a standard protocol. Crit Care Med 1990; 18: 689–693.PubMedCrossRefGoogle Scholar
  46. 46.
    Cain SM, Curtis SE: Experimental models of pathologic oxygen supply dependency. Crit Care Med 1991; 19: 603–612.PubMedCrossRefGoogle Scholar
  47. 47.
    Reinhart K, Bloos F, Spies C: Vasoactive drug therapy in sepsis. In: Sibbald WJ, Vincent JL (eds) Clinical Trials for the Treatment of Sepsis. Berlin, Springer, 1995; 207–224.CrossRefGoogle Scholar
  48. 48.
    Zhang H, Spapen H, Nguyen DN, et al: Protective effects of N-acetylcysteine in endotoxemia. Am J Physiol 1994; 266: H1746–H1754.PubMedGoogle Scholar
  49. 49.
    Petros A, Bennet D, Vallance P: Effect of nitric oxide synthase inhibitors on hypotension in patients with septic shock. Lancet 1991; 338: 1557–1558.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Fred Bongard

There are no affiliations available

Personalised recommendations