brief review of septic cardiomyopathy and possible preventive strategies

ABSTRACT

Sepsis induced cardiomyopathy leads to significant morbidity and mortality if not identified early and treated judiciously. A lot is written and discussed about it but till date, the syndrome remains a dilemma. Clinicians have used various modalities like beta- blockers to reduce heart rate, polymyxin B hemofiltration to neutralize the endotoxinemia thereby interfering with the progression of myocardial dysfunction, statins for its anti - inflammatory, antithrombotic and antioxidative properties thereby causing myocardial protection in the same way as it does in coronary artery disease. Ivabradine is a novel drug which is the first If current inhibitor that causes selective heart rate reduction without any antihypertensive effect like beta blockers and doesn't affect hemodynamics. Its still in the trial stage. At present the only effective measure seems to be intensive fluid therapy, aggressive source control and use of broad spectrum antibiotics and maintenance of optimum hemodynamics with vasoactive agents