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      Dynamic myocardial depression in septic cardiomyopathy

      abstract
      1 , , 1 , 1
      Critical Care
      BioMed Central
      34th International Symposium on Intensive Care and Emergency Medicine
      18-21 March 2014

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          Abstract

          Introduction Depression of left ventricular contractility appears in many diseases resulting from various etiology factors. One of the most interesting features of septic cardiomyopathy is the significant dynamic myocardial depression that is commonly observed. In this context, the objective of the present work is to characterize clinically, by laboratory, by echocardiography, and by invasive measures the patients with septic cardiomyopathy. Methods A single-center database investigates all patients who were admitted and treated for severe sepsis or septic shock in the ICU over a period of 2 years (November 2011 to October 2013), and who were discharged with a diagnosis of septic cardiomyopathy or new left ventricular dysfunction. The clinical, laboratory, echocardiography, and invasive measures, and clinical outcome were recorded. Results From the 105 patients that were investigated, 15 patients were found with septic cardiomyopathy. Septic cardiomyopathy is more prevalent among men (60%). Patients with septic cardiomyopathy have an increased prevalence of immune compromised disease (46%), and hypertension (40%). There was a need for mechanical respiratory support for 86% of patients. The improvement in cardiac function occurred at an average of 6.9 days. E. coli is the commonest bacterial pathogen (33%). Laboratory findings show elevated liver enzyme and kidney function impairment in all patients. Thirty-three percent of patients were treated with N-acetyl cysteine, and 46% were treated with renal replacement therapy. High CRP was observed in all patients. Paroxysmal atrial fibrillation was diagnosed in 46%. Invasive measures in 50% of the patients have demonstrated high cardiac index (CI) and low systemic vascular resistant index (SVRI) on their admission, and 93% demonstrate low CI and high SVRI a few hours later. Hospitalization stay was between 3 and 42 days with an average of 14.6 days. Conclusion Septic cardiomyopathy is more common among immune compromised patients. It is characterized by dynamic changes in the cardiac function based on echocardiography and invasive measures. A persistent hyperkinetic state was associated with high mortality rate. In addition to echocardiography follow-up, invasive monitoring even in their admission is of great importance for more effective and adequate treatment.

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          Author and article information

          Conference
          Crit Care
          Crit Care
          Critical Care
          BioMed Central
          1364-8535
          1466-609X
          2014
          17 March 2014
          : 18
          : Suppl 1
          : P249
          Affiliations
          [1 ]The Chaim Sheba Medical Center affiliated to the Tel-Aviv University, Ramatgan, Israel
          Article
          cc13439
          10.1186/cc13439
          4068631
          eb80055a-bdd4-42f7-a893-98d58186b4a5
          Copyright © 2014 Darawshe et al.; licensee BioMed Central Ltd.

          This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

          34th International Symposium on Intensive Care and Emergency Medicine
          Brussels, Belgium
          18-21 March 2014
          History
          Categories
          Poster Presentation

          Emergency medicine & Trauma
          Emergency medicine & Trauma

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