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Myocardial depression during sepsis

R D Weisel, L Vito, R C Dennis

    American Journal of Surgery
    |April 1, 1977
    PubMed
    Summary
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    In septic patients, cardiac function improved with fluid resuscitation, but survivors showed a better response. Myocardial dysfunction was evident in both groups, especially in nonsurvivors.

    Area of Science:

    • Critical Care Medicine
    • Cardiology
    • Physiology

    Background:

    • Sepsis frequently leads to cardiovascular dysfunction.
    • Understanding the cardiac response to fluid resuscitation in sepsis is crucial for patient management.

    Purpose of the Study:

    • To evaluate the cardiac response to volume loading in severely septic patients.
    • To compare the cardiac performance between survivors and nonsurvivors of sepsis.

    Main Methods:

    • Fifty severely septic patients underwent rapid infusion of albumin or whole blood.
    • Cardiac index (CI) and left ventricular stroke work index (LVSWI) were measured as pulmonary arterial wedge pressure (PAWP) increased.

    Main Results:

    • Surviving patients exhibited greater increases in CI and LVSWI with rising PAWP compared to nonsurvivors.

    Related Experiment Videos

  • Nearly half of patients in both groups showed decreased CI and LVSWI at higher PAWP, indicating myocardial dysfunction.
  • Nonsurvivors displayed a lower cardiac performance curve slope, suggesting myocardial depression or negative inotropic effects.

    • Conclusions:

    • Septic patients demonstrate impaired myocardial function, with nonsurvivors showing more pronounced depression.
    • Factors like cardiac ischemia and respiratory failure negatively impact the cardiac response to volume loading.
    • Hepatic and renal failure were associated with a favorable cardiac output response.