Cardiovascular Function in Septic Shock

  • M. M. Parker
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1996)


Septic shock is a common life-threatening problem in intensive care units, and is one of the major causes of mortality in the critically ill. The effects of sepsis on the cardiovascular system have been the subject of much investigation over the past 20 years and yet remain incompletely understood. Many advances have been made in recent years in understanding the pathophysiology of cardiovascular dysfunction in septic shock with the hope that better understanding of the pathophysiologic events in the patient with sepsis will contribute to more effective treatment.


Nitric Oxide Septic Shock Cardiac Index Coronary Blood Flow Myocardial Depression 
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.


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  1. 1.
    Wilson RF, Thal AP, Kindling PH, Grifka T, Ackerman E (1965) Hemodynamic measurements in septic shock. Ann Surg 91: 121–129Google Scholar
  2. 2.
    Parker MM, Shelhamer JH, Natanson C, Alling DW, Parrillo JE (1987) Serial cardiovascular variables in survivors and non-survivors of human septic shock: Heart rate as an early predictor of prognosis. Crit Care Med 15: 923–929PubMedCrossRefGoogle Scholar
  3. 3.
    Ahmed AJ, Kruse JA, Haupt MT, Chandrasekar PH, Carlson RW (1991) Hemodynamic responses to gram-positive versus gram-negative sepsis in critically ill patients with and without circulatory shock. Crit Care Med 19: 1520–1525PubMedCrossRefGoogle Scholar
  4. 4.
    Parker MM, Ognibene FP, Rogers P, Shelhamer JH, Masur H, Parrillo IE (1994) Severe Pneumocystis carinii pneumonia produces a hyperdynamic profIle similar to bacterial pneumonia with sepsis. Crit Care Med 22: 50–54PubMedGoogle Scholar
  5. 5.
    Weisel RD, Vito L, Dennis RC, Valeri CR, Hechtman HB (1977) Myocardial depression during sepsis. Am J Surg 133: 512–521PubMedCrossRefGoogle Scholar
  6. 6.
    Packman MI, Rackow EC (1983) Optimum left heart filling pressure during fluid resuscitation of patients with hypovolemic and septic shock. Crit Care Med 11: 165–169PubMedCrossRefGoogle Scholar
  7. 7.
    Ognibene FP, Parker MM, Natanson C, Shelhamer JH, Parrillo IE (1988) Depressed left ventricular performance: Response to volume infusion in patients with sepsis and septic shock. Chest 93: 903–910PubMedCrossRefGoogle Scholar
  8. 8.
    Tuchschmidt J, Oblitas D, Fried JC (1991) Oxygen consumption in sepsis and septic shock. Crit Care Med 19: 664–671PubMedCrossRefGoogle Scholar
  9. 9.
    Tuchschmidt J, Fried J, Astiz M, Rackow E (1992) Elevation of cardiac output and oxygen delivery improves outcome in septic shock. Chest 102: 216–220PubMedCrossRefGoogle Scholar
  10. 10.
    Gattinoni L, Brazzi L, Pelosi P, et al (1995) A trial of goal-oriented hemodynamic therapy in critically ill patients. N Engl J Med 333: 1025–1032PubMedCrossRefGoogle Scholar
  11. 11.
    Parker MM, Shelhamer JH, Bacharach SL, et al (1984) Profound but reversible myocardial depression in patients with septic shock. Ann Intern Med 100: 483–490PubMedGoogle Scholar
  12. 12.
    Parker MM, McCarthy KE, Ognibene FP, Parrillo IE (1990) Right ventricular dysfunction and dilatation, similar to left ventricular changes, characterize the cardiac depression of septic shock in humans. Chest 97: 126–131PubMedCrossRefGoogle Scholar
  13. 13.
    Cunnion RE, Schaer GL, Parker MM, Natanson C, Parrillo IE (1986) The coronary circulation in human septic shock. Circulation 73: 637–644PubMedCrossRefGoogle Scholar
  14. 14.
    Parrillo IE, Burch C, Shelhamer JH, Parker MM, Natanson C, Schuette W (1985) A circulating myocardial depressant substance in humans with septic shock. J Clin Invest 76: 1539–1553PubMedCrossRefGoogle Scholar
  15. 15.
    Natanson C, Eichenholz PW, Danner RL, et al (1989) Endotoxin and tumor necrosis factor challenges in dogs simulate the cardiovascular profIle of human septic shock. J Exp Med 169: 823–832PubMedCrossRefGoogle Scholar
  16. 16.
    Danner RL, Elin RJ, Hosseini JM, Wesley RA, Reilly JM, Parrillo IE (1991) Endotoxemia in human septic shock. Chest 99: 169–175PubMedCrossRefGoogle Scholar
  17. 17.
    Suffredini AF, Fromm RE, Parker MM, et al (1989) The cardiovascular response of normal humans to the administration of endotoxin. N Engl J Med 321 : 280–287PubMedCrossRefGoogle Scholar
  18. 18.
    Michie HR, Manogue KR, Spriggs DR, et al (1988) Detection of circulating tumor necrosis factor after endotoxin administration. N Engl J Med 318: 1481–1486PubMedCrossRefGoogle Scholar
  19. 19.
    Lorente JA, Landin L, Renes E, et al (1993) Role of nitric oxide in the hemodynamic changes of sepsis. Crit Care Med 21: 759–767PubMedCrossRefGoogle Scholar
  20. 20.
    Cobb JP, Natanson C, Hoffman WD, et al (1992) NW-amino-L-arginine, an inhibitor of nitric oxide synthase, raises vascular resistance but increases mortality rates in awake canines challenged with endotoxin. J Exp Med 176: 1175–1182PubMedCrossRefGoogle Scholar
  21. 21.
    Finkel MS, Oddis CV, Jacob TD, Watkins SC, Hatder BG, Simmons RL (1992) Negative inotropic effects of cytokines on the heart mediated by nitric oxide. Science 257: 387–389PubMedCrossRefGoogle Scholar
  22. 22.
    Nava E, Palmer RMJ, Moncada S (1991) Inhibition of nitric oxide synthesis in septic shock: How much is beneficial? Lancet 338: 1555–1557PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1996

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  • M. M. Parker

There are no affiliations available

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