Myocardial dysfunction in sepsis – diagnostics and therapy

Česká verzia

Authors: J. Maláska; M. Slezák; K. Muriová; J. Stašek; P. Ševčík
Authors place of work: Klinika anesteziologie, resuscitace a intenzivní medicíny Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MU Dr. Pavel Ševčík, CSc.
Published in the journal: Vnitř Lék 2010; 56(3): 226-232
Category: Reviews

Summary

Incidence of myocardial dysfunction in studies with severe sepsis patients is up to two thirds of patients. On the other side, patients with normal echocardiography have some type of myocardial injury, which can be detected by elevated serum levels of troponins and natriuretic peptides. Strong prognostic value of these markers regarding morbidity and mortality of septic patients indicates an important role of this „occult“ myocardial injury. Therapeutical interventions should take place only in situation in that low cardiac output is not capable to ensure metabolic demands of tissues. Nowadays, because of detrimental effects of classical inotropes, new strategies are under investigation. Namely levosimendan is promising alternative, not only related to its inotropic effects. Early diagnostics, assessment of prognosis and therapeutic strategy in patients with SMD are challenging for continuing research and for clinicians of different specialities.

Key words:
sepsis – myocardial dysfunction – troponin – BN – echocardiography – inotropes – levosimendan

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