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Right ventricular performance in septic shock: a combined radionuclide and hemodynamic study
Journal of the American College of Cardiology
|November 1, 1984
Summary
Right ventricular dysfunction is common in septic shock, affecting ejection fraction in over half of patients. This dysfunction can occur with normal or abnormal left ventricular function and may improve with treatment targeting afterload and contractility.
Area of Science:
- Cardiology
- Critical Care Medicine
Background:
- Septic shock is a complex syndrome with significant cardiovascular implications.
- The role of the right ventricle in septic shock pathophysiology requires further elucidation.
Purpose of the Study:
- To investigate the prevalence and characteristics of right ventricular dysfunction in patients with septic shock.
- To identify factors associated with right ventricular dysfunction and its impact on clinical outcomes.
Main Methods:
- Simultaneous radionuclide ventriculography and right heart catheterization were performed in 25 septic shock patients.
- Right ventricular ejection fraction (RVEF) and left ventricular ejection fraction (LVEF) were assessed.
- Hemodynamic parameters, including cardiac output and afterload, were evaluated.
Main Results:
- A depressed RVEF (<38%) was observed in 13 of 25 patients.
- Right ventricular dysfunction occurred across a spectrum of cardiac output and was seen with normal or abnormal LVEF.
- No clear correlation was found between right ventricular afterload and depressed RVEF; no specific clinical or hemodynamic predictor identified patients with dysfunction.
Conclusions:
- Right ventricular dysfunction is a frequent complication of septic shock, potentially more common than previously recognized.
- Potential etiologies include altered right ventricular afterload and myocardial contractility.
- Therapeutic strategies aimed at reducing right ventricular afterload and enhancing contractility may benefit septic shock patients with RV dysfunction.