Skip to main content

Ventricular Dysfunction during Sepsis

  • Conference paper
Yearbook of Intensive Care and Emergency Medicine

Part of the book series: Yearbook of Intensive Care and Emergency Medicine ((YEARBOOK,volume 1995))

Abstract

Sepsis occurs in about 1% of all hospitalized patients [1] and frequently complicates other treatable conditions from which the patients could otherwise recover. The incidence of sepsis is approximately 1500 cases per million population per year [2]. The average length of stay in hospital for patients with sepsis is 18 days [3]. In 40% of these patients sepsis is complicated by cardiovascular dysfunction leading to septic shock [4, 5]. Mortality rates rise from 20 to 30% in sepsis [4, 6] to approximately 40 to 70% in septic shock [4, 7]. This high mortality rate has not changed substantially over the past 20 years [6]. These data suggest that the human and financial burden of treating patients with sepsis is very high and that cardiovascular dysfunction during sepsis doubles the magnitude of the problem.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Balk RA, Bone RC (1989) The septic syndrome. Crit Care Clin 5: 1–8

    PubMed  CAS  Google Scholar 

  2. Ziegler EJ, Fisher CJ, Sprung CL, et al (1991) Treatment of gram-negative bacteremia and septic shock with HA-1A human monoclonal antibody against endotoxin. A randomized, double-blind, placebo-controlled trial. N Engl J Med 324: 429–436

    Article  PubMed  CAS  Google Scholar 

  3. Statistics Canada (1989–91) Health Reports, Supplement No. 1, volume 2, number 1, and Supplement No. 11, volume 2, number 1. Canadian Centre for Health Information, Ottawa

    Google Scholar 

  4. Bone RC, Fisher CJ Jr, Clemmer TP, et al (1987) A controlled clinical trial of high-dose methylprednisolone in the treatment of severe sepsis and septic shock. N Engl J Med 317: 653–658

    Article  PubMed  CAS  Google Scholar 

  5. Hess ML, Hastillo A, Greenfield LJ (1981) Spectrum of cardiovascular function during gram-negative sepsis. Prog Cardiovasc Dis 23: 279–298

    Article  PubMed  CAS  Google Scholar 

  6. Hinshaw L, Peduzzi P, Young E, Sprung C, Shatney C, Sheagren JN (1987) Effect of high-dose glucocorticoid therapy on mortality in patients with clinical signs of systemic sepsis. N Engl J Med 317: 659–665

    Article  Google Scholar 

  7. Sprung CL, Panagiota VC, Marcial EH, Pierce M, Gelbard MA, Long WM (1984) The effects of high dose corticosteroids in patients with septic shock. A prospective, controlled study. N Engl J Med 311: 1137–1143

    Article  PubMed  CAS  Google Scholar 

  8. Parker MM, Shelhamer JH, Bacharach SL, Green MV, Natanson C, Frederick TM (1984) Profound but reversible myocardial depression in patients with septic shock. Ann Int Med 100: 483–490

    PubMed  CAS  Google Scholar 

  9. Parrillo JE, 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: 1539–1553

    Article  PubMed  CAS  Google Scholar 

  10. Parker MM, Suffredini AF, Natanson C, Ognibene FP, Shelhamer JH, Parrillo JE (1989) Responses of left ventricular function in survivors and non-survivors of septic shock. J Crit Care 4: 19–25

    Article  Google Scholar 

  11. Russell JA, Ronco JJ, Lockhat D, Belzberg A, Kiess M, Dodek PM (1990) Oxygen delivery and consumption and ventricular preload are greater in survivors than in non-survivors of the adult respiratory distress syndrome. Am Rev Respir Dis 141: 659–665

    Article  PubMed  CAS  Google Scholar 

  12. Suffredini AF, Fromm RE, Parker MM, Brenner M, Kovacs JA, Wesley RA (1989) The cardiovascular response of normal humans to the administration of endotoxin. N Engl J Med 321: 280–287

    Article  PubMed  CAS  Google Scholar 

  13. Natanson C, Fink MP, Ballantyne HK, MacVittie TJ, Conklin JJ, Parrillo JE (1986) Gram-negative bacteremia produces both severe systolic and diastolic cardiac dysfunction in a canine model that simulates human septic shock. J Clin Invest 78: 259–270

    Article  PubMed  CAS  Google Scholar 

  14. Walley KR, Hebert PC, Wakai Y, Wilcox P, Road J, Cooper J (1994) Decrease in left ventricular contractility after tumor necrosis factor infusion in dogs. J Appl Physiol 76: 1060–1067

    PubMed  CAS  Google Scholar 

  15. Kass DA, Maughan WL, Guo ZM, Kono A, Sunagawa K, Sagawa K (1987) Comparative influence of load versus inotropic state on indexes of ventricular contractility: Experimental and theoretical analysis based on pressure/volume relationships. Circulation 76: 1422–1436

    Article  PubMed  CAS  Google Scholar 

  16. Walley KR, Cooper DJ (1991) Diastolic stiffness impairs left ventricular function during hypovolemic shock in pigs. Am J Physiol 260: H702–H712

    PubMed  CAS  Google Scholar 

  17. Walley KR, Becker CJ, Hogan RA, Teplinsky K, Wood LDH (1988) Progressive hypoxemia limits left ventricular oxygen consumption and contractility. Circulation Res 63: 849–859

    PubMed  CAS  Google Scholar 

  18. Thomas F, Smith J, Orme J Jr, Clemmer T, Hagan A, Elliott G (1986) Reversible segmental myocardial dysfunction in septic shock. Crit Care Med 14: 587–588

    Article  PubMed  CAS  Google Scholar 

  19. Cunnion RE, Parrillo JE (1989) Myocardial dysfunction in sepsis — recent insights. Chest 95: 941–945

    Article  PubMed  CAS  Google Scholar 

  20. Stahl TJ, Alden PB, Ring WS, Madoff RC, Cerra FB (1990) Sepsis-induced diastolic dysfunction in chronic canine peritonitis. Am J Physiol 258: H625–H633

    PubMed  CAS  Google Scholar 

  21. Gilbert JC, Glantz SA (1988) Determinants of left ventricular filling and of the diastolic pressure-volume relation. Circulation 64: 827–852

    Google Scholar 

  22. Gomez A, Wang R, Unruh H, Light RB, Bose D, Chau T (1990) Hemofiltration reverses left ventricular dysfunction during sepsis in dogs. Anesthesiology 73: 671–685

    Article  PubMed  CAS  Google Scholar 

  23. Natanson C (1990) Studies using a canine model to investigate the cardiovascular abnormality of and potential therapies for septic shock. Clin Res 38: 206–214

    PubMed  CAS  Google Scholar 

  24. Finkel MS, Oddis CV, Jacob TD, Watkins SC, Hattler BG, Simmons RL (1992) Negative inotropic effects of cytokines on the heart mediated by nitric oxide. Science 257: 387–389

    Article  PubMed  CAS  Google Scholar 

  25. Hesse DG, Tracey KJ, Fong Y, Manogue KR, Palladino MA, Cerami A (1988) Cytokine appearance in human endotoxemia and primate bacteremia. Surg Gynecol Obst 166: 147–153

    CAS  Google Scholar 

  26. Liu MS, Xuan Y (1986) Mechanism of endotoxin-induced impairment in Na+-Ca2+ exchange in canine myocardium. Am J Physiol 251: R1078–R1085

    PubMed  CAS  Google Scholar 

  27. Carmona RH, Tsao T, Dae M, Trunkey DD (1985) Myocardial dysfunction in septic shock. Arch Surg 120: 30–35

    Article  PubMed  CAS  Google Scholar 

  28. Hung J, Lew WYW (1993) Cellular mechanisms of endotoxin-induced myocardial depression in rabbits. Circ Res 73: 125–134

    PubMed  CAS  Google Scholar 

  29. Brigham KL, Meyrick B (1986) Endotoxin and lung injury. Am Rev Respir Dis 133: 913–927

    PubMed  CAS  Google Scholar 

  30. Haslett C, Worthen GS, Giclas PC, Morrison DC, Henson JE, Henson PM (1987) The pulmonary vasculature sequestration of neutrophils in endotoxemia is initiated by an effect of endotoxin on the neutrophil of the rabbit. Am Rev Respir Dis 136: 9–18

    Article  PubMed  CAS  Google Scholar 

  31. Tracey KJ, Lowry SF (1990) The role of cytokine mediators in septic shock. Adv Surg 23: 21–56

    PubMed  CAS  Google Scholar 

  32. Song H, Tyml K (1993) Evidence for sensing and integration of biological signals by the capillary network. Am J Physiol 265: H1235–H1242

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag Berlin Heidelberg

About this paper

Cite this paper

Walley, K.R. (1995). Ventricular Dysfunction during Sepsis. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 1995. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79154-3_42

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-79154-3_42

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-58256-4

  • Online ISBN: 978-3-642-79154-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics