Septic shock, the most severe complication of sepsis, accounts for similar to 10% of all admissions to intensive care. Our understanding of its complex pathophysiology remains incomplete but clearly involves stimulation of the immune system with subsequent inflammation and microvascular dysfunction. Cardiovascular dysfunction is pronounced and characterized by elements of hypovolaemic, cytotoxic, and distributive shock. In addition, significant myocardial depression is commonly observed. This septic cardiomyopathy is characterized by biventricular impairment of intrinsic myocardial contractility, with a subsequent reduction in left ventricular (LV) ejection fraction and LV stroke work index. This review details the myocardial dysfunction observed in adult septic shock, and discusses the underlying pathophysiology. The utility of using the regulatory protein troponin for the detection of myocardial dysfunction is also considered. Finally, options for the management of sepsis-induced LV hypokinesia are discussed, including the use of levosimendan.
机构:
Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, EnglandUniv London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, England
Belcher, E
Mitchell, J
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Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, EnglandUniv London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, England
Mitchell, J
Evans, T
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h-index: 0
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Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, EnglandUniv London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, England
机构:
Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Bouhemad, Belaid
Nicolas-Robin, Armelle
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h-index: 0
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Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Nicolas-Robin, Armelle
Arbelot, Charlotte
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h-index: 0
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Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Arbelot, Charlotte
Arthaud, Martine
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h-index: 0
机构:
Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Lab Biol Urgences, F-75252 Paris, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Arthaud, Martine
Feger, Frederic
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h-index: 0
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Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Lab Biol Urgences, F-75252 Paris, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
机构:
Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, FranceGrp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Charpentier, J
Luyt, CE
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机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Luyt, CE
Fulla, Y
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h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Fulla, Y
Vinsonneau, C
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h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Vinsonneau, C
Cariou, A
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h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Cariou, A
Grabar, S
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h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Grabar, S
Dhainaut, JF
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h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Dhainaut, JF
Mira, JP
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h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Mira, JP
Chiche, JD
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
机构:
Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, EnglandUniv London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, England
Belcher, E
Mitchell, J
论文数: 0引用数: 0
h-index: 0
机构:
Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, EnglandUniv London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, England
Mitchell, J
Evans, T
论文数: 0引用数: 0
h-index: 0
机构:
Univ London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, EnglandUniv London Imperial Coll Sci Technol & Med, Royal Brompton Hosp, Sch Med, Crit Care Unit, London SW3 6NP, England
机构:
Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Bouhemad, Belaid
Nicolas-Robin, Armelle
论文数: 0引用数: 0
h-index: 0
机构:
Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Nicolas-Robin, Armelle
Arbelot, Charlotte
论文数: 0引用数: 0
h-index: 0
机构:
Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Arbelot, Charlotte
Arthaud, Martine
论文数: 0引用数: 0
h-index: 0
机构:
Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Lab Biol Urgences, F-75252 Paris, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
Arthaud, Martine
Feger, Frederic
论文数: 0引用数: 0
h-index: 0
机构:
Univ Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Lab Biol Urgences, F-75252 Paris, FranceUniv Paris 06, Assistance Publ Hop Paris, Hosp Pitie Salpetriere, Dept Anesthesiol, F-75252 Paris 05, France
机构:
Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, FranceGrp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Charpentier, J
Luyt, CE
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Luyt, CE
Fulla, Y
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Fulla, Y
Vinsonneau, C
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Vinsonneau, C
Cariou, A
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Cariou, A
Grabar, S
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Grabar, S
Dhainaut, JF
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Dhainaut, JF
Mira, JP
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France
Mira, JP
Chiche, JD
论文数: 0引用数: 0
h-index: 0
机构:Grp Hosp Cochin St Vincent de Paul La Roche Guyon, Med Intens Care Unit, Paris, France