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Right ventricular pump dysfunction with acute experimental septic shock.

J L Zellner1, F G Spinale, F A Crawford

  • 1Department of Surgery, Medical University of South Carolina, Charleston 29425.

The Journal of Surgical Research
|January 11, 1991
PubMed
Summary
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Acute bacterial septic shock severely impairs right ventricular (RV) function early on. This study shows decreased RV ejection fraction and increased afterload, indicating significant RV pump dysfunction in septic shock.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Pathophysiology

Background:

  • Right ventricular (RV) function is not well understood at the start of acute bacterial septic shock.
  • Early characterization of RV function is crucial for understanding septic shock progression.

Purpose of the Study:

  • To investigate and characterize RV function during the early stages of acute bacterial septic shock.
  • To determine the impact of septic shock on RV performance and hemodynamics.

Main Methods:

  • Utilized a porcine model of acute septic shock induced by Pseudomonas aeruginosa infusion.
  • Employed a volumetric thermodilution catheter for serial measurements of RV function.
  • Monitored RV ejection fraction, volumes, cardiac output, and various pressures (arterial, central venous, pulmonary arterial).

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Main Results:

  • RV ejection fraction and stroke volume decreased significantly by 30 minutes and remained depressed.
  • Mean arterial pressure was significantly reduced, while pulmonary vascular resistance and RV stroke work increased.
  • No significant changes were observed in RV end-diastolic volume or central venous pressure, suggesting no change in preload.

Conclusions:

  • Severe RV pump dysfunction occurs early in acute bacterial septic shock.
  • The dysfunction is characterized by reduced RV ejection fraction and increased afterload, not preload.
  • These findings highlight the critical early impact of sepsis on RV performance.