Mustafa Ala, Obholz Jacob, Hitt Nathaniel, Rattin Richard
Internal Medicine, MercyOne North Iowa Medical Center, Mason City, USA.
Interventional Cardiology, MercyOne North Iowa Medical Center, Mason City, USA.
Cureus. 2021 Oct 19;13(10):e18889. doi: 10.7759/cureus.18889. eCollection 2021 Oct.
The inflammatory response triggered by sepsis can frequently cause reversible myocardial depression termed sepsis-induced cardiomyopathy. The resulting pathologic changes are often self-limiting and cardiac function returns to baseline following resolution of the underlying exacerbating factors. The following case examines a patient with septic shock and sepsis-induced cardiomyopathy that, despite maximal medical therapy, required mechanical support with an Impella assist device for seven days. To the best of our knowledge and research, this represents the longest documented use of an Impella heart pump in septic shock and associated sepsis-induced cardiomyopathy. Utilization of mechanical support in the setting of septic shock has seen growing interest in recent years, but more structured studies need to be conducted for better understanding of their overall effect on morbidity and mortality.
脓毒症引发的炎症反应常常会导致可逆性心肌抑制,即脓毒症诱导的心肌病。由此产生的病理变化通常是自限性的,在潜在加重因素消退后,心脏功能会恢复到基线水平。以下病例研究的是一名患有感染性休克和脓毒症诱导的心肌病的患者,尽管接受了最大程度的药物治疗,但仍需要使用Impella辅助装置进行七天的机械支持。据我们所知和研究,这是有记录以来Impella心脏泵在感染性休克及相关脓毒症诱导的心肌病中使用时间最长的案例。近年来,在感染性休克的情况下使用机械支持越来越受到关注,但需要进行更具系统性的研究,以便更好地了解其对发病率和死亡率的总体影响。