Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Myocardial depression characterizes the fatal course of septic shock.

Vincent, JL and Gris, P and Coffernils, M and Leon, M and Pinsky, Michael R and Reuse, C and Kahn, RJ (1992) Myocardial depression characterizes the fatal course of septic shock. Surgery, 111 (6). 660 - 667. ISSN 0039-6060

[img] Plain Text (licence)
Available under License : See the attached license file.

Download (1kB)

Abstract

The relationship between cardiac and vascular abnormalities was studied in 68 patients with established septic shock. At time of hemodynamic evaluation, after initial resuscitation, there was no significant difference in arterial pressure, pulmonary artery pressure, cardiac filling pressures, and cardiac index between the 38 survivors of shock and the 30 patients who died of shock, but the left ventricular stroke work index and the right ventricular (RV) stroke work index were higher in survivors than in those who died (mean +/- SD: 25.0 +/- 9.1 vs 20.1 +/- 9.4 gm/m2 [p less than 0.05] and 6.6 +/- 3.6 vs 4.8 +/- 2.8 gm/m2 [p less than 0.05], respectively). Survivors had also higher thermodilution RV ejection fraction and lower RV end-diastolic volumes than had those who died (43.9% +/- 16.3% vs 31.1% +/- 13.7% [p less than 0.01] and 82 +/- 30 vs 99 +/- 31 ml/m2 [p less than 0.05], respectively). Calculated systemic vascular resistance was similar in the two groups, but vasopressors had been required in 22 (58%) of 38 survivors and 25 (83%) of 30 patients who died (p less than 0.01). Moreover, when the patients were separated into two groups according to their cardiac output, higher or lower than 3 L/min/m2, in both subgroups patients who died had lower blood pressure than had survivors. Blood lactate levels were significantly lower in survivors than in nonsurvivors (5.1 +/- 2.1 vs 8.1 +/- 4.7 mEq/L, p less than 0.01). Final data obtained before recovery of shock or death indicated that the survivors had higher arterial pressure, lower pulmonary artery pressure and right atrial pressure, higher stroke volume, and higher RV ejection fraction than had the patients who died. No survivors but all patients who died had been treated with vasopressors. These data therefore indicate that death as a result of septic shock is characterized by both myocardial depression and altered vascular tone and both are probably interrelated.


Share

Citation/Export:
Social Networking:
Share |

Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Vincent, JL
Gris, P
Coffernils, M
Leon, M
Pinsky, Michael Rpinsky@pitt.eduPINSKY
Reuse, C
Kahn, RJ
Date: June 1992
Date Type: Publication
Journal or Publication Title: Surgery
Volume: 111
Number: 6
Publisher: Elsevier Science
Page Range: 660 - 667
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0039-6060
Article Type: Research Article
PubMed ID: 1595062
Date Deposited: 01 Mar 2012 20:12
Last Modified: 01 Nov 2017 14:05
URI: http://d-scholarship.pitt.edu/id/eprint/11115

Metrics

Monthly Views for the past 3 years

Plum Analytics


Actions (login required)

View Item View Item