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Related Experiment Videos

Right ventricular dysfunction in septic patients.

T Mitsuo1, S Shimazaki, H Matsuda

  • 1Department of Critical Care Medicine and Traumatology, Kyorin University Hospital, Tokyo, Japan.

Critical Care Medicine
|May 1, 1992
PubMed
Summary
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Septic patients exhibit reduced right ventricular ejection fraction compared to trauma patients, despite similar high cardiac output. This suggests potential right ventricular contractility impairment in sepsis.

Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Hemodynamics

Background:

  • The hyperdynamic circulatory phase in trauma and sepsis presents complex hemodynamic challenges.
  • Understanding right ventricular function is crucial for managing these critically ill patients.

Purpose of the Study:

  • To compare right ventricular ejection fraction (RVEF) between trauma and septic patients during the hyperdynamic phase.
  • To investigate differences in hemodynamic parameters, including cardiac output and afterload, between these patient groups.

Main Methods:

  • A prospective study involving 11 trauma and 10 septic patients in a university hospital ICU.
  • Right ventricular ejection fraction was measured using thermodilution with a modified pulmonary artery catheter.
  • Exclusion criteria included circulatory shock and need for catecholamines to maintain systolic BP > 90 mm Hg.

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Main Results:

  • Both trauma and septic groups displayed high mean cardiac output.
  • Septic patients showed a significantly reduced right ventricular ejection fraction (36% ± 9.7%) compared to trauma patients (47% ± 7.0%).
  • End-diastolic volume index was significantly increased in septic patients versus trauma patients, with no significant difference in afterload.

Conclusions:

  • Septic patients have significantly reduced right ventricular ejection fraction compared to trauma patients.
  • Despite similar hyperdynamic states, impaired right ventricular contractility may be present in sepsis.
  • Hemodynamic monitoring reveals distinct right ventricular functional differences between sepsis and trauma.