Cardiac dysfunction in critical illness

Curr Opin Anaesthesiol. 2018 Apr;31(2):158-164. doi: 10.1097/ACO.0000000000000572.

Abstract

Purpose of review: Sepsis and septic shock are prevalent conditions that are likely to increase in prevalence in the future. Given the high mortality and morbidity associated with sepsis and sepsis-induced cardiac dysfunction, we must continue to make advances in knowledge of the complex physiologic interactions and how we may target specific mediators for potential therapeutic options in the future.

Recent findings: Multiple biomarkers have been discovered, which when assayed in sepsis-induced cardiomyopathy predict morbidity and mortality. With increased sensitivity of echocardiography, we can diagnose subclinical cardiac dysfunction, which may have future implications for slowing or preventing progressive dysfunction.

Summary: Sepsis-induced cardiomyopathy is the result of complicated interactions between the pathogen, the body's response to infection, and iatrogenic injury. Interplay between inflammatory, metabolic, and adrenergic systems results in direct and indirect myocardial injury leading to decreases in both systolic and diastolic cardiac function. As the interactions are further elucidated with additional research into other proteins and mediators, new treatment options can be researched. VIDEO ABSTRACT.

Publication types

  • Review

MeSH terms

  • Biomarkers / analysis
  • Cardiomyopathies / diagnosis
  • Cardiomyopathies / epidemiology
  • Cardiomyopathies / physiopathology*
  • Cardiomyopathies / therapy
  • Critical Illness / epidemiology
  • Critical Illness / therapy*
  • Echocardiography
  • Humans
  • Intensive Care Units
  • Prevalence
  • Sepsis / epidemiology
  • Sepsis / physiopathology*
  • Sepsis / therapy

Substances

  • Biomarkers