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ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2018, Number 4

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An Med Asoc Med Hosp ABC 2018; 63 (4)

Successful use of extracorporeal membrane oxygenation in patients with ventricular dysfunction due to sepsis

Carrillo MNE, Rubio MC, González MFJ, Franco GJ

Language: Spanish
References: 25
Page: 283-287
PDF size: 225.54 Kb.


ABSTRACT

The Third International Consensus defined sepsis as an organic dysfunction that compromises life, caused by a dysregulated response of the host to an infection. This inappropriate host response consecutively causes organ dysfunction, disability and death. In sepsis, mortality is estimated at 10%, whereas in patients with septic shock, mortality generally exceeds 40%. Given the central role of circulatory impairment in disrupting the function of multiple organs, understanding cardiac dysfunction in sepsis is critical. Cardiac dysfunction in sepsis can manifest itself in multiple different ways, including left and/or right ventricular failure during systole or diastole, inadequate cardiac output and oxygen delivery, or primary myocardial cellular injury. In sepsis-induced cardiomyopathy, the myocardium is functionally and structurally injured by inflammatory cytokines and mitochondrial dysfunction. This process has three characteristics: left ventricular dilatation, depressed ejection fraction, and recovery in 7–10 days. Extracorporeal membrane oxygenation is a modified circuit of the cardiopulmonary bypass, which provides prolonged support for reversible pulmonary or cardiac pathological states. The role of extracorporeal membrane oxygenation as a supportive therapy in adult patients with septic shock is unclear. A recent study showed promising long-term results and suggested that extracorporeal membrane oxygenation may be a valuable option in adult patients with refractory cardiac dysfunction during severe septic shock.


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