LEFT VENTRICULAR PERFORMANCEIN RESPONSE TO VOLUME INFUSION IN SEPSIS

容量输注是脓毒症所致休克的初始治疗方法。 因为我们单位最近产生的证据表明 感染性休克患者心肌功能受抑 已经分析了容量期间的左心功能 使用从肺组织获得的连续血流动力学数据进行输液 动脉导管和放射性核素电影血管造影术。对以下问题的回应 体液在危重的、非败血症的“对照组”和 败血症和感染性休克患者。已收到所有组 统计上相似的输液量都增加了 他们的肺毛细血管楔压在统计学上相似 金额。左心室每搏功，一种测量 心功能，对容量输注无反应 脓毒症患者，表明由于 致败血症。也有初步证据表明，有一种趋势是 心室顺应性异常，表现为减少 脑室对容量输注的反应能力 败血症患者。进一步的临床研究正在进行中，以更好地 阐明左心室这些改变的发病机制 败血症患者的表现。

Volume infusion is the initial management of shock due to sepsis. Because of recent evidence generated in our unit that there is depressed myocardial performance in human septic shock, we have analyzed left ventricular performance during volume infusion using serial hemodynamic data obtained from pulmonary artery catheters and radionuclide cineangiography. Responses to fluid were assessed in critically - ill, nonseptic "controls" and in patients with sepsis and septic shock. All groups received statistically similar amounts of volume infusion and all increased their pulmonary capillary wedge pressure by statistically similar amounts. Left ventricular stroke work, a measurement of ventricular performance, was not responsive to volume infusion in septic patients, indicating abnormal ventricular contractility due to sepsis. There is also preliminary evidence of a trend toward abnormal ventricular compliance as manifested by decreased ability of the ventricle to dilate in response to volume infusion in septic patients. Further clinical studies are underway to better clarify the pathogenesis of these alterations in left ventricular performance in septic patients.