Left ventricular systolic and diastolic function in septic shock
The identification of myocardial dysfunction in septic shock has not yet been fully elucidated. We therefore studied patients with persistently vasopressor-dependent septic shock, both with invasive haemodynamic monitoring and transoesophageal two-dimensional and Doppler echocardiography (TEE). Pros...
Gespeichert in:
| Veröffentlicht in: | Intensive care medicine 1997-05, Vol.23 (5), p.553-560 |
|---|---|
| Hauptverfasser: | , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 560 |
|---|---|
| container_issue | 5 |
| container_start_page | 553 |
| container_title | Intensive care medicine |
| container_volume | 23 |
| creator | POELAERT, J DECLERCK, C VOGELAERS, D COLARDYN, F VISSER, C. A |
| description | The identification of myocardial dysfunction in septic shock has not yet been fully elucidated. We therefore studied patients with persistently vasopressor-dependent septic shock, both with invasive haemodynamic monitoring and transoesophageal two-dimensional and Doppler echocardiography (TEE).
Prospective study.
General ICU in University Hospital.
All patients were monitored with arterial and pulmonary artery catheters. Haemodynamics were obtained concomitantly with TEE measurements. TEE was performed at three levels: a) a midpapillary short axis view of the left ventricle (LV) in order to measure end-systolic and end-diastolic areas; b) at the level of both the mitral valve for early (E) and late (A) filling parameters and c) the level of the right upper pulmonary vein for systolic (S) and diastolic (D) filling characteristics. Each parameter was characterised by maximal flow velocity and time velocity integral.
Although the measurements of cardiac index demonstrated a wide range, three subsets of patients were identified post hoc after analysis on the basis of different Doppler patterns: first, patients with a LV without regional wall motion abnormalities and both E/A and S/D greater than 1 (group 1); second, patients with a comparable haemodynamic condition, apparently normal LV systolic function but with altered Doppler patterns: S/D less than 1 in conjunction with E/A more than 1 (group 2); finally, patients with compromised global LV systolic function, E/A less than 1 and S/D less than (group 3).
Notwithstanding the known various interfering factors which limit the broad applicability of TEE to determine LV function in septic shock, our data suggest that cardiac dysfunction in septic shock shows a continuum from isolated diastolic dysfunction to both diastolic and systolic ventricular failure. These data strengthen the need of including the evaluation of pulmonary venous Doppler parameters in each investigation in order to obtain supplementary information to interpret diastolic function of the LV in septic shock patients. |
| doi_str_mv | 10.1007/s001340050372 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79080830</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2656775921</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-64f469084cc59206f23022c53b7970526247c78134950c4b5e223348d941d0de3</originalsourceid><addsrcrecordid>eNpd0M1LwzAYBvAgypzTo0ehoHirvnmTJulNGX7BwIueS5ammNmlM2mF_fdGVgZ6Csn740nyEHJO4YYCyNsIQBkHKIBJPCBTyhnmFJk6JFNgHHMuOB6TkxhXSUpR0AmZlAi0QDUldwvb9Nm39X1wZmh1yOI29l3rTKZ9ndVOj7tm8KZ3nc-cz6Ld9OkofnTm85QcNbqN9mxcZ-T98eFt_pwvXp9e5veL3HBK-1zwhosSFDemSJeLBhkgmoItZSmhQIFcGqnST8oCDF8WFpExruqS0xpqy2bkepe7Cd3XYGNfrV00tm21t90QK5nCQTFI8PIfXHVD8OltFQWKFHipWFL5TpnQxRhsU22CW-uwTaj67bX602vyF2PqsFzbeq_HItP8apzraHTbBO2Ni3uGQrFSIPsB8Sx72g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1012104983</pqid></control><display><type>article</type><title>Left ventricular systolic and diastolic function in septic shock</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>POELAERT, J ; DECLERCK, C ; VOGELAERS, D ; COLARDYN, F ; VISSER, C. A</creator><creatorcontrib>POELAERT, J ; DECLERCK, C ; VOGELAERS, D ; COLARDYN, F ; VISSER, C. A</creatorcontrib><description>The identification of myocardial dysfunction in septic shock has not yet been fully elucidated. We therefore studied patients with persistently vasopressor-dependent septic shock, both with invasive haemodynamic monitoring and transoesophageal two-dimensional and Doppler echocardiography (TEE).
Prospective study.
General ICU in University Hospital.
All patients were monitored with arterial and pulmonary artery catheters. Haemodynamics were obtained concomitantly with TEE measurements. TEE was performed at three levels: a) a midpapillary short axis view of the left ventricle (LV) in order to measure end-systolic and end-diastolic areas; b) at the level of both the mitral valve for early (E) and late (A) filling parameters and c) the level of the right upper pulmonary vein for systolic (S) and diastolic (D) filling characteristics. Each parameter was characterised by maximal flow velocity and time velocity integral.
Although the measurements of cardiac index demonstrated a wide range, three subsets of patients were identified post hoc after analysis on the basis of different Doppler patterns: first, patients with a LV without regional wall motion abnormalities and both E/A and S/D greater than 1 (group 1); second, patients with a comparable haemodynamic condition, apparently normal LV systolic function but with altered Doppler patterns: S/D less than 1 in conjunction with E/A more than 1 (group 2); finally, patients with compromised global LV systolic function, E/A less than 1 and S/D less than (group 3).
Notwithstanding the known various interfering factors which limit the broad applicability of TEE to determine LV function in septic shock, our data suggest that cardiac dysfunction in septic shock shows a continuum from isolated diastolic dysfunction to both diastolic and systolic ventricular failure. These data strengthen the need of including the evaluation of pulmonary venous Doppler parameters in each investigation in order to obtain supplementary information to interpret diastolic function of the LV in septic shock patients.</description><identifier>ISSN: 0342-4642</identifier><identifier>EISSN: 1432-1238</identifier><identifier>DOI: 10.1007/s001340050372</identifier><identifier>PMID: 9201528</identifier><identifier>CODEN: ICMED9</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Adult ; Aged ; Analysis of Variance ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Critical care ; Doppler effect ; Echocardiography, Doppler, Color ; Echocardiography, Transesophageal ; Emergency and intensive care: infection, septic shock ; Female ; Flow velocity ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Hemodynamics ; Humans ; Hypotension ; Intensive care ; Intensive care medicine ; Linear Models ; Male ; Medical sciences ; Middle Aged ; Mitral Valve - diagnostic imaging ; Mitral Valve - physiopathology ; Prospective Studies ; Pulmonary arteries ; Pulmonary Veins - diagnostic imaging ; Pulmonary Veins - physiopathology ; Sepsis ; Shock, Septic - classification ; Shock, Septic - diagnostic imaging ; Shock, Septic - physiopathology ; Veins & arteries</subject><ispartof>Intensive care medicine, 1997-05, Vol.23 (5), p.553-560</ispartof><rights>1997 INIST-CNRS</rights><rights>Springer-Verlag Berlin Heidelberg 1997</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-64f469084cc59206f23022c53b7970526247c78134950c4b5e223348d941d0de3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2683962$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9201528$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>POELAERT, J</creatorcontrib><creatorcontrib>DECLERCK, C</creatorcontrib><creatorcontrib>VOGELAERS, D</creatorcontrib><creatorcontrib>COLARDYN, F</creatorcontrib><creatorcontrib>VISSER, C. A</creatorcontrib><title>Left ventricular systolic and diastolic function in septic shock</title><title>Intensive care medicine</title><addtitle>Intensive Care Med</addtitle><description>The identification of myocardial dysfunction in septic shock has not yet been fully elucidated. We therefore studied patients with persistently vasopressor-dependent septic shock, both with invasive haemodynamic monitoring and transoesophageal two-dimensional and Doppler echocardiography (TEE).
Prospective study.
General ICU in University Hospital.
All patients were monitored with arterial and pulmonary artery catheters. Haemodynamics were obtained concomitantly with TEE measurements. TEE was performed at three levels: a) a midpapillary short axis view of the left ventricle (LV) in order to measure end-systolic and end-diastolic areas; b) at the level of both the mitral valve for early (E) and late (A) filling parameters and c) the level of the right upper pulmonary vein for systolic (S) and diastolic (D) filling characteristics. Each parameter was characterised by maximal flow velocity and time velocity integral.
Although the measurements of cardiac index demonstrated a wide range, three subsets of patients were identified post hoc after analysis on the basis of different Doppler patterns: first, patients with a LV without regional wall motion abnormalities and both E/A and S/D greater than 1 (group 1); second, patients with a comparable haemodynamic condition, apparently normal LV systolic function but with altered Doppler patterns: S/D less than 1 in conjunction with E/A more than 1 (group 2); finally, patients with compromised global LV systolic function, E/A less than 1 and S/D less than (group 3).
Notwithstanding the known various interfering factors which limit the broad applicability of TEE to determine LV function in septic shock, our data suggest that cardiac dysfunction in septic shock shows a continuum from isolated diastolic dysfunction to both diastolic and systolic ventricular failure. These data strengthen the need of including the evaluation of pulmonary venous Doppler parameters in each investigation in order to obtain supplementary information to interpret diastolic function of the LV in septic shock patients.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Critical care</subject><subject>Doppler effect</subject><subject>Echocardiography, Doppler, Color</subject><subject>Echocardiography, Transesophageal</subject><subject>Emergency and intensive care: infection, septic shock</subject><subject>Female</subject><subject>Flow velocity</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Intensive care</subject><subject>Intensive care medicine</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mitral Valve - diagnostic imaging</subject><subject>Mitral Valve - physiopathology</subject><subject>Prospective Studies</subject><subject>Pulmonary arteries</subject><subject>Pulmonary Veins - diagnostic imaging</subject><subject>Pulmonary Veins - physiopathology</subject><subject>Sepsis</subject><subject>Shock, Septic - classification</subject><subject>Shock, Septic - diagnostic imaging</subject><subject>Shock, Septic - physiopathology</subject><subject>Veins & arteries</subject><issn>0342-4642</issn><issn>1432-1238</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpd0M1LwzAYBvAgypzTo0ehoHirvnmTJulNGX7BwIueS5ammNmlM2mF_fdGVgZ6Csn740nyEHJO4YYCyNsIQBkHKIBJPCBTyhnmFJk6JFNgHHMuOB6TkxhXSUpR0AmZlAi0QDUldwvb9Nm39X1wZmh1yOI29l3rTKZ9ndVOj7tm8KZ3nc-cz6Ld9OkofnTm85QcNbqN9mxcZ-T98eFt_pwvXp9e5veL3HBK-1zwhosSFDemSJeLBhkgmoItZSmhQIFcGqnST8oCDF8WFpExruqS0xpqy2bkepe7Cd3XYGNfrV00tm21t90QK5nCQTFI8PIfXHVD8OltFQWKFHipWFL5TpnQxRhsU22CW-uwTaj67bX602vyF2PqsFzbeq_HItP8apzraHTbBO2Ni3uGQrFSIPsB8Sx72g</recordid><startdate>19970501</startdate><enddate>19970501</enddate><creator>POELAERT, J</creator><creator>DECLERCK, C</creator><creator>VOGELAERS, D</creator><creator>COLARDYN, F</creator><creator>VISSER, C. A</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>19970501</creationdate><title>Left ventricular systolic and diastolic function in septic shock</title><author>POELAERT, J ; DECLERCK, C ; VOGELAERS, D ; COLARDYN, F ; VISSER, C. A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-64f469084cc59206f23022c53b7970526247c78134950c4b5e223348d941d0de3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Critical care</topic><topic>Doppler effect</topic><topic>Echocardiography, Doppler, Color</topic><topic>Echocardiography, Transesophageal</topic><topic>Emergency and intensive care: infection, septic shock</topic><topic>Female</topic><topic>Flow velocity</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Intensive care</topic><topic>Intensive care medicine</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mitral Valve - diagnostic imaging</topic><topic>Mitral Valve - physiopathology</topic><topic>Prospective Studies</topic><topic>Pulmonary arteries</topic><topic>Pulmonary Veins - diagnostic imaging</topic><topic>Pulmonary Veins - physiopathology</topic><topic>Sepsis</topic><topic>Shock, Septic - classification</topic><topic>Shock, Septic - diagnostic imaging</topic><topic>Shock, Septic - physiopathology</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>POELAERT, J</creatorcontrib><creatorcontrib>DECLERCK, C</creatorcontrib><creatorcontrib>VOGELAERS, D</creatorcontrib><creatorcontrib>COLARDYN, F</creatorcontrib><creatorcontrib>VISSER, C. A</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Intensive care medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>POELAERT, J</au><au>DECLERCK, C</au><au>VOGELAERS, D</au><au>COLARDYN, F</au><au>VISSER, C. A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Left ventricular systolic and diastolic function in septic shock</atitle><jtitle>Intensive care medicine</jtitle><addtitle>Intensive Care Med</addtitle><date>1997-05-01</date><risdate>1997</risdate><volume>23</volume><issue>5</issue><spage>553</spage><epage>560</epage><pages>553-560</pages><issn>0342-4642</issn><eissn>1432-1238</eissn><coden>ICMED9</coden><abstract>The identification of myocardial dysfunction in septic shock has not yet been fully elucidated. We therefore studied patients with persistently vasopressor-dependent septic shock, both with invasive haemodynamic monitoring and transoesophageal two-dimensional and Doppler echocardiography (TEE).
Prospective study.
General ICU in University Hospital.
All patients were monitored with arterial and pulmonary artery catheters. Haemodynamics were obtained concomitantly with TEE measurements. TEE was performed at three levels: a) a midpapillary short axis view of the left ventricle (LV) in order to measure end-systolic and end-diastolic areas; b) at the level of both the mitral valve for early (E) and late (A) filling parameters and c) the level of the right upper pulmonary vein for systolic (S) and diastolic (D) filling characteristics. Each parameter was characterised by maximal flow velocity and time velocity integral.
Although the measurements of cardiac index demonstrated a wide range, three subsets of patients were identified post hoc after analysis on the basis of different Doppler patterns: first, patients with a LV without regional wall motion abnormalities and both E/A and S/D greater than 1 (group 1); second, patients with a comparable haemodynamic condition, apparently normal LV systolic function but with altered Doppler patterns: S/D less than 1 in conjunction with E/A more than 1 (group 2); finally, patients with compromised global LV systolic function, E/A less than 1 and S/D less than (group 3).
Notwithstanding the known various interfering factors which limit the broad applicability of TEE to determine LV function in septic shock, our data suggest that cardiac dysfunction in septic shock shows a continuum from isolated diastolic dysfunction to both diastolic and systolic ventricular failure. These data strengthen the need of including the evaluation of pulmonary venous Doppler parameters in each investigation in order to obtain supplementary information to interpret diastolic function of the LV in septic shock patients.</abstract><cop>Heidelberg</cop><cop>Berlin</cop><pub>Springer</pub><pmid>9201528</pmid><doi>10.1007/s001340050372</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0342-4642 |
| ispartof | Intensive care medicine, 1997-05, Vol.23 (5), p.553-560 |
| issn | 0342-4642 1432-1238 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_79080830 |
| source | MEDLINE; SpringerNature Journals |
| subjects | Adult Aged Analysis of Variance Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Critical care Doppler effect Echocardiography, Doppler, Color Echocardiography, Transesophageal Emergency and intensive care: infection, septic shock Female Flow velocity Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Hemodynamics Humans Hypotension Intensive care Intensive care medicine Linear Models Male Medical sciences Middle Aged Mitral Valve - diagnostic imaging Mitral Valve - physiopathology Prospective Studies Pulmonary arteries Pulmonary Veins - diagnostic imaging Pulmonary Veins - physiopathology Sepsis Shock, Septic - classification Shock, Septic - diagnostic imaging Shock, Septic - physiopathology Veins & arteries |
| title | Left ventricular systolic and diastolic function in septic shock |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-23T14%3A51%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Left%20ventricular%20systolic%20and%20diastolic%20function%20in%20septic%20shock&rft.jtitle=Intensive%20care%20medicine&rft.au=POELAERT,%20J&rft.date=1997-05-01&rft.volume=23&rft.issue=5&rft.spage=553&rft.epage=560&rft.pages=553-560&rft.issn=0342-4642&rft.eissn=1432-1238&rft.coden=ICMED9&rft_id=info:doi/10.1007/s001340050372&rft_dat=%3Cproquest_cross%3E2656775921%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1012104983&rft_id=info:pmid/9201528&rfr_iscdi=true |