Clinical review: Myocardial depression in sepsis and septic shock.

Clinical review: Myocardial depression in sepsis and septic shock.
复制标题

DOI:
10.1186/cc1822
复制
发表时间:
2002-12
期刊:
Critical care (London, England)
影响因子:
--
通讯作者:
Kumar A
Kumar A
中科院分区:
其他
文献类型:
--
作者:
Court O;Kumar A;Parrillo JE;Kumar A

文献摘要

参考文献

被引文献

相似文献

心肌功能障碍常伴随严重败血症和感染性休克。虽然心肌抑制以前被认为是一个终末事件,但现在很清楚,大多数严重脓毒症和感染性休克患者都存在心功能障碍,如双室扩张和射血分数降低。尽管脓毒性休克患者存在液体复苏依赖的高动力状态,但心肌抑制仍然存在,这种状态通常持续到死亡或康复。幸存者的心脏功能通常在7-10天内恢复。心肌功能障碍似乎不是由于心肌灌注不足,而是由于循环抑制因子,包括细胞因子肿瘤坏死因子α和IL-1β。在细胞水平上,心肌收缩力的降低似乎是由一氧化氮依赖性和一氧化氮非依赖性机制诱导的。现就脓毒症所致心肌抑制的临床表现及分子/细胞机制作一综述。
Myocardial dysfunction frequently accompanies severe sepsis and septic shock. Whereas myocardial depression was previously considered a preterminal event, it is now clear that cardiac dysfunction as evidenced by biventricular dilatation and reduced ejection fraction is present in most patients with severe sepsis and septic shock. Myocardial depression exists despite a fluid resuscitation-dependent hyperdynamic state that typically persists in septic shock patients until death or recovery. Cardiac function usually recovers within 7–10 days in survivors. Myocardial dysfunction does not appear to be due to myocardial hypoperfusion but due to circulating depressant factors, including the cytokines tumor necrosis factor alpha and IL-1β. At a cellular level, reduced myocardial contractility seems to be induced by both nitric oxide-dependent and nitric oxide-independent mechanisms. The present paper reviews both the clinical manifestations and the molecular/cellular mechanisms of sepsis-induced myocardial depression.
DOI: 10.1016/0002-8703(85)90163-2
发表时间: 1985-01-01
影响因子: 4.8
作者:
ELLRODT, AG;RIEDINGER, MS;MURATA, GH
通讯作者: MURATA, GH
DOI: 10.1161/01.cir.75.3.533
发表时间: 1987-03-01
期刊: CIRCULATION
影响因子: 37.8
作者:
DHAINAUT, JF;HUYGHEBAERT, MF;RAICHVARG, D
通讯作者: RAICHVARG, D
DOI: 10.1097/00005373-199206000-00003
发表时间: 1992-06-01
影响因子: --
作者:
DEMEULES, JE;PIGULA, FA;GAMELLI, RL
通讯作者: GAMELLI, RL
DOI: 10.1001/jama.271.23.1836
发表时间: 1994-06-15
影响因子: 120.7
作者:
FISHER, CJ;DHAINAUT, JFA;STABLEIN, D
通讯作者: STABLEIN, D
DOI: 10.1097/00003246-199907000-00018
发表时间: 1999-07-01
影响因子: 8.8
作者:
Cain, BS;Meldrum, DR;Harken, AH
通讯作者: Harken, AH