Many of the patients in this series required vasopressor therapy during the course of septic shock. It could be argued that the hemodynamic and myocardial changes found are related in part to the use of vasopressors. There are no differences in the data and subsequent conclusions, however, in the mean initial hemodynamic findings, the right […]
Iii this study, 39 patients with blood culture-positive septic shock and a characteristic hyperdynamic hemodynamic profile were found to have biventricular cardiac dysfunction. This was characterized by depression of both the right and left ventricular ejection fractions with simultaneous dilatation of both ventricles. In the survivors, these abnormalities were severe at shock onset, but returned […]
Radionuclide Determined Ejection Fractions and Ventricular Volumes Table 2 shows the initial and final right and left ventricular ejection fractions and the right and left ventricular end-diastolic volume indices for the survivors and nonsurvivors of septic shock. Survivors had a substantial depression of initial left ventricular ejection fraction at 0.31 and a depressed initial right […]
Catheter-Derived Hemodynamic Studies Table 1 shows the hemodynamic changes from initial to final study in the 22 survivors and 17 nonsurvivors of septic shock.
Radionuclide Ventriculography Based on our previous studies of left ventricular function, four serial radionuclide scans (at shock onset, and at three, seven, and ten days following shock) were planned for each patient. In the present study, at least two radionuclide ventriculography studies were performed on each patient. The first scan was done as near to […]
Patient Population Thirty nine patients with septic shock were studied in the Medical Intensive Care Unit at the Clinical Center of the National Institutes of Health, Bethesda, Md. All patients met our clinical definition of septic shock: fever (temperature >38°C), hypotension (mean arterial pressure <60 mm Hg), and positive blood cultures. The mean age of […]
Septic shock in humans is usually characterized by a hyperdynamic hemodynamic profile. During human septic shock, reversible depression of left ventricular ejection fraction and dilatation of the left ventricle have been described using radionuclide angiography or echocardiography. These changes in left ventricular function and size are transient and return toward normal in survivors at seven […]