Precipitation of Cardiac Failure in Endotoxin Shock

摘要

Experiments have been carried out to assay cardiac function in the intermediate stage of endotoxin shock. Performance curves were conducted by altering afterload through a wide range in order to compare myocardial work performance, coronary hemodynamics and cardiac metabolism in both control and endotoxin shocked dogs. Results clearly demonstrate the elicitation of heart failure 7-9 hours after endotoxin, as revealed by markedly elevated LVEDP, decreased dP/dT and the necessity of using an inotropic agent to drive the tailing ventricle through the imposed afterload performance curve. The myocardial dysfunction was profound and generally irreversible although temporary restoration of function was demonstrated by infusion of a beta adrenergic stimulating agent. No single parameter was discovered or identified which would serve a prognostic value in predetermining cardiac function prior to testing the heart with work performance stresses. The cause of failure has been discussed. (Author)