Cardiac function in an ovine model of endotoxemia.

Eight awake sheep were monitored with ultrasonic crystals, positioned at the anterior and posterior left ventricular wall. A left-sided intraventricular pressure transducer and a right ventricular ejection fraction catheter were positioned in the right and left hearts, respectively. After administration of endotoxin (Escherichia coli, LPS 1.5 micrograms/kg in 30 min), the hemodynamic variables showed a triphasic course. Phase I, (0-1 hr post LPS) was characterized by an increased pulmonary artery pressure and a decreased right ventricular ejection fraction. The inability of the right ventricle to compensate for the increased preload resulted in a fall of the left ventricular preload, stroke volume, and cardiac output. Three hours after LPS administration a second drop of the cardiac output was noted (phase II). This occurred as a result of a fall in preload. Eight hours post LPS a hyperdynamic phase (phase III) was distinguished, with a high cardiac output and a low systemic vascular resistance. During this time there was evidence of probable reduced myocardial contractility.