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2008, Número 3

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Med Crit 2008; 22 (3)


Disfunción cardiaca inducida por sepsis

Carrillo ER, Carrillo CJR, Carrillo CLD, Vázquez OZY

Idioma: Español
Referencias bibliográficas: 63
Paginas: 124-130
Archivo PDF: 158.65 Kb.


RESUMEN

La disfunción miocárdica se asocia con frecuencia a sepsis grave y choque séptico. En un inicio se consideró como un evento preterminal, pero ahora es claro que la disfunción cardiaca que se manifiesta como dilatación biventricular y reducción en la fracción de expulsión se presenta en la mayoría de los enfermos con sepsis grave y choque séptico. La depresión miocárdica secundaria a sepsis es independiente de la reanimación con volumen, la cual la puede acentuar. La función cardiaca se normaliza en los sobrevivientes entre el séptimo al décimo día. La disfunción cardiaca no parece ser debida a hipoperfusión sino a factores depresores circulantes, dentro de los que se incluye al factor de necrosis tumoral alfa y a la IL-1β. A nivel celular y molecular los mecanismos involucrados son dependientes e independientes de óxido nítrico. Este artículo revisa las manifestaciones clínicas y los mecanismos moleculares y celulares de la depresión miocárdica inducida por sepsis.


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