Zetina TH, Rentería AMC, Bonilla RLC

Language: Spanish
References: 48
Page: 102-110
PDF size: 151.64 Kb.

ABSTRACT

Cardiac dysfunction is often present in patients with septic shock. Significant myocardial depression has been demonstrated; an initial depressed ejection fraction, increased end-diastolic volume and dilated ventricles has been observed in survivors. Myocardial ischemia, circulating depressant substances, altered regulatory functions of the vascular endothelium and decreased myocardial responsiveness to catecholamines are some of the possible mechanisms by which myocardial depression of septic shock can be explained. The initial treatment of septic shock is fluid resuscitation, but it must remembered that ventricular performance is not normal and therefore the response to volumen infusion may not be as great as migth be expected. The increase of oxygen to supra normal values as therapeutic goals is controversial. Increase in oxygen delivery were associated with increase in oxygen consumption, but it do not improve the survival rate. If fluid resucitation fails to reversed hypotension and inadequate organ perfusion, treatment with inotropes and vasopressors must be considered. The management of septic shock includes antibiotics, drainage of septic focci, renal and respiratory support, nutrition, etc., also.

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