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Sepsis-related cardiogenic shock
F Jardin1, D Brun-Ney, B Auvert
1Department of Cardiology, Hôpital Ambroise Paré Boulogne, France.
Critical Care Medicine
|October 1, 1990
Summary
Septic shock can cause severe heart dysfunction, identified through hemodynamic and echocardiographic assessments. Some patients experience reversible cardiogenic shock due to myocardial depression, while others show milder cardiac impairment.
Area of Science:
- Cardiology
- Critical Care Medicine
- Physiology
Background:
- Septic shock is a complex condition with significant cardiovascular manifestations.
- Understanding the spectrum of cardiac dysfunction in sepsis is crucial for effective management.
Purpose of the Study:
- To characterize cardiovascular abnormalities in patients with septic shock.
- To differentiate between types of cardiac dysfunction observed in sepsis-related circulatory failure.
Main Methods:
- Serial hemodynamic measurements and two-dimensional echocardiography were performed at the bedside.
- Patients were categorized into groups based on initial hemodynamic profiles and cardiac function.
Main Results:
- Six patients (group 1) presented with severe left and right ventricular depression, indicative of sepsis-related cardiogenic shock, reversible with inotropic support.
- Fifteen patients (group 2) showed increased cardiac index with low systemic vascular resistance, suggesting mild to moderate left ventricular systolic dysfunction.
- All patients maintained normal left ventricular end-diastolic volume.
Conclusions:
- Septic shock can manifest as profound, reversible cardiogenic shock due to myocardial depression or milder systolic dysfunction.
- Early hemodynamic and echocardiographic assessment is vital for identifying distinct cardiovascular patterns in septic shock.
- Myocardial depression in septic shock appears to be a transient phenomenon, responsive to therapeutic interventions.