Vnitr Lek 2010, 56(3):226-232

Myocardial dysfunction in sepsis - diagnostics and therapy

J. Maláska*, M. Slezák, K. Muriová, J. Stašek, P. Ševčík
Klinika anesteziologie, resuscitace a intenzivní medicíny Lékařské fakulty MU a FN Brno, pracoviště Bohunice, přednosta prof. MUDr. Pavel Ševčík, CSc.

Incidence of myocardial dysfunction in studies with severe sepsis patients is up to two thirds of patients. On the other side, patients with normal echocardiography have some type of myocardial injury, which can be detected by elevated serum levels of troponins and natriuretic peptides. Strong prognostic value of these markers regarding morbidity and mortality of septic patients indicates an important role of this "occult" myocardial injury. Therapeutical interventions should take place only in situation in that low cardiac output is not capable to ensure metabolic demands of tissues. Nowadays, because of detrimental effects of classical inotropes, new strategies are under investigation. Namely levosimendan is promising alternative, not only related to its inotropic effects. Early diagnostics, assessment of prognosis and therapeutic strategy in patients with SMD are challenging for continuing research and for clinicians of different specialities.

Keywords: sepsis; myocardial dysfunction; troponin; BN; echocardiography; inotropes; levosimendan

Received: October 21, 2009; Accepted: January 25, 2010; Published: March 1, 2010  Show citation

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Maláska J, Slezák M, Muriová K, Stašek J, Ševčík P. Myocardial dysfunction in sepsis - diagnostics and therapy. Vnitr Lek. 2010;56(3):226-232.
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