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Septic Cardiomyopathy: Age-Dependent Physiology and Hemodynamic Aspects-A Narrative Review
Marianna Miliaraki1, George Briassoulis2, Evangelia Dardamani1
1Division of Pediatric Intensive Care, School of Medicine, University of Crete, 71300 Heraklion, Greece.
Children (Basel, Switzerland)
|February 27, 2026
Summary
Septic cardiomyopathy presents differently in adults and children, requiring age-specific cardiovascular assessments. Advanced monitoring and phenotype-guided interventions are crucial for improving outcomes in septic cardiomyopathy.
Area of Science:
- Critical Care Medicine
- Cardiology
- Pediatrics
Background:
- Septic cardiomyopathy (SCM) is a complex sepsis complication involving inflammation, autonomic issues, and microcirculation changes.
- While sharing mechanisms, SCM presents distinct hemodynamic responses in pediatric and adult patients due to age-related cardiovascular physiology.
Purpose of the Study:
- To review current understanding of septic cardiomyopathy pathophysiology, hemodynamic monitoring, and therapeutic strategies.
- To highlight age-dependent differences in SCM presentation and management.
Main Methods:
- A structured narrative review of clinical and experimental studies from 2000-2025.
- Searches were conducted on PubMed and critical care literature.
- Inclusion criteria focused on SCM pathophysiology, hemodynamics, and therapies across age groups.
Main Results:
- Adult SCM often shows hyperdynamic, vasoplegic states; pediatric SCM typically presents with hypodynamic profiles.
- Conventional echocardiography may miss subtle myocardial impairment; advanced tools like strain echocardiography and multimodal monitoring offer better detection.
- Limited pediatric data necessitates extrapolation from adult studies for therapeutic guidance.
Conclusions:
- SCM management requires a time-dependent, physiology-driven approach with integrated, multimodal cardiovascular assessment.
- Age-specific hemodynamic profiles underscore the need for standardized diagnostics and validated monitoring tools.
- Phenotype-guided interventions are essential for improving outcomes in both adult and pediatric septic cardiomyopathy.
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