Chapter: Cardiac Dysfunction in Septic Shock[Show abstract] [Hide abstract] ABSTRACT: Clinically, we observe septic shock as increased capillary permeability, hypovolemia, decreased cardiac output, tachycardia, and hypotension. Sepsis-related systolic and diastolic dysfunction are often characterized by depressed ejection fraction, decreased contractility, and impaired relaxation. Mechanisms of cardiac dysfunction require understanding in order to better attack the clinical challenges of treating septic shock. The inflammatory cascade, autonomic dysregulation, adrenergic receptor downregulation, abnormal myocardial calcium utilization, biochemical uncoupling of mitochondrial energy production, and apoptosis have been implicated in sepsis- related cardiovascular dysfunction. The cellular and biochemical relationships that mitigate the pathophysiology of systolic and diastolic dysfunction in sepsis will be discussed in this chapter.
- [Show abstract] [Hide abstract] ABSTRACT: Endotracheal intubation and mechanical ventilation are required for the majority of critically ill patients in tertiary care intensive care units (ICUs) . During mechanical ventilation, patients often have imbalances in regional lung ventilation due to heterogeneity of lung mechanics. The current methods generally available for assessing lung function in mechanically ventilated patients include arterial blood gas analysis and graphic waveforms from ventilators (flow, pressure and volume over time as well as pressure-volume, pressure-flow and flow-volume loops). At best, these methods reflect only overall lung function, while failing to give information on disparate regional functionality. Unlike data collected from the ventilator or the blood, lung imaging allows for regional assessment of anatomy or function. Methods which provide the capability of quantifying these regional differences in mechanically ventilated patients are of great interest.
Article: Do Not (Over) Resuscitate