Disfunción miocárdica en la sepsis

Myocardial dysfunction appears in 25% of patients with severe sepsis and in 50% of patients with septic shock, even in the presence of hyper dynamic states. It is characterized by a reduction in left ventricle ejection fraction, that reverts at the seventh to tenth day of evolution. Right ventricular dysfunction and diastolic left ventricular dysfunction can also appear. There is no consensus if an increase in end diastolic volume is part of the syndrome. High troponin or brain natriuretic peptide levels are associated with myocardial dysfunction and a higher mortality. The pathogenesis of myocardial dysfunction is related to micro and macro circulatory changes, infammatory response, oxidative stress, intracellular calcium management disturbances, metabolic changes, autonomic dysfunction, activation of apoptosis, mitochondrial abnormalities and a derangement in catecholaminergic stimulation. Since there is no specifc treatment for myocardial dysfunction, its management requires an adequate multi systemic support to maintain perfusion pressures and systemic fows suffcient for the regional and global demands.

Bibliographic Details

Main Authors:	ANDRESEN,MAX, REGUEIRA,TOMÁS
Format:	Digital revista
Language:	Spanish / Castilian
Published:	Sociedad Médica de Santiago 2010
Online Access:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872010000700015
Tags:	Add Tag No Tags, Be the first to tag this record!