Disfunción miocárdica en la sepsis / Myocardial dysfunction in sepsis
Rev. méd. Chile
;
138(7): 888-896, July 2010. ilus
Article
in Spanish
| LILACS
| ID: lil-567595
ABSTRACT
Myocardial dysfunction appears in 25 percent of patients with severe sepsis and in 50 percent of patients with septic shock, even in the presence of hyper dynamic states. It is characterized by a reduction in left ventricle ejection fraction, that reverts at the seventh to tenth day of evolution. Right ventricular dysfunction and diastolic left ventricular dysfunction can also appear. There is no consensus if an increase in end diastolic volume is part of the syndrome. High troponin or brain natriuretic peptide levels are associated with myocardial dysfunction and a higher mortality. The pathogenesis of myocardial dysfunction is related to micro and macro circulatory changes, infammatory response, oxidative stress, intracellular calcium management disturbances, metabolic changes, autonomic dysfunction, activation of apoptosis, mitochondrial abnormalities and a derangement in catecholaminergic stimulation. Since there is no specifc treatment for myocardial dysfunction, its management requires an adequate multi systemic support to maintain perfusion pressures and systemic fows suffcient for the regional and global demands.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Sepsis
/
Cardiomyopathies
Limits:
Humans
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2010
Type:
Article
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