Title |
Sepsis-induced myocardial dysfunction: pathophysiology and management
|
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Published in |
Journal of Intensive Care, March 2016
|
DOI | 10.1186/s40560-016-0148-1 |
Pubmed ID | |
Authors |
Yasuyuki Kakihana, Takashi Ito, Mayumi Nakahara, Keiji Yamaguchi, Tomotsugu Yasuda |
Abstract |
Sepsis is aggravated by an inappropriate immune response to invading microorganisms, which occasionally leads to multiple organ failure. Several lines of evidence suggest that the ventricular myocardium is depressed during sepsis with features of diastolic dysfunction. Potential candidates responsible for septic cardiomyopathy include pathogen-associated molecular patterns (PAMPs), cytokines, and nitric oxide. Extracellular histones and high-mobility group box 1 that function as endogenous damage-associated molecular patterns (DAMPs) also contribute to the myocardial dysfunction associated with sepsis. If untreated, persistent shock causes cellular injury and the liberation of further DAMPs. Like PAMPs, DAMPs have the potential to activate inflammation, creating a vicious circle. Early infection control with adequate antibiotic care is important during septic shock to decrease PAMPs arising from invasive microorganisms. Early aggressive fluid resuscitation as well as the administration of vasopressors and inotropes is also important to reduce DAMPs generated by damaged cells although excessive volume loading, and prolonged administration of catecholamines might be harmful. This review delineates some features of septic myocardial dysfunction, assesses its most common underlying mechanisms, and briefly outlines current therapeutic strategies and potential future approaches. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Mexico | 3 | 9% |
United States | 3 | 9% |
Ecuador | 2 | 6% |
Brazil | 2 | 6% |
United Kingdom | 2 | 6% |
Spain | 1 | 3% |
Malaysia | 1 | 3% |
Venezuela, Bolivarian Republic of | 1 | 3% |
Argentina | 1 | 3% |
Other | 2 | 6% |
Unknown | 14 | 44% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 27 | 84% |
Scientists | 2 | 6% |
Practitioners (doctors, other healthcare professionals) | 2 | 6% |
Science communicators (journalists, bloggers, editors) | 1 | 3% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 2 | <1% |
Pakistan | 1 | <1% |
South Africa | 1 | <1% |
Sweden | 1 | <1% |
Mexico | 1 | <1% |
United Kingdom | 1 | <1% |
Unknown | 472 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Postgraduate | 61 | 13% |
Other | 48 | 10% |
Student > Master | 47 | 10% |
Student > Bachelor | 43 | 9% |
Student > Ph. D. Student | 42 | 9% |
Other | 115 | 24% |
Unknown | 123 | 26% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 253 | 53% |
Nursing and Health Professions | 20 | 4% |
Biochemistry, Genetics and Molecular Biology | 15 | 3% |
Pharmacology, Toxicology and Pharmaceutical Science | 13 | 3% |
Immunology and Microbiology | 10 | 2% |
Other | 35 | 7% |
Unknown | 133 | 28% |