Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, United States.
Department of Anesthesiology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, QC, Canada.
J Cardiothorac Vasc Anesth. 2022 Oct;36(10):3916-3926. doi: 10.1053/j.jvca.2022.04.025. Epub 2022 Apr 22.
Sepsis-induced cardiomyopathy (SCM) is an increasingly recognized problem encountered in critical care medicine. It generally is characterized as a decrease in left, right, or biventricular ejection fraction followed by a recovery of function over a period of days to weeks. Venoarterial extracorporeal membrane oxygenation (ECMO) has been used for the treatment of adults with various etiologies of shock, including cardiogenic and septic shock. This review summarizes current pathophysiologic mechanisms leading to SCM and provides a detection and treatment algorithm for SCM, as well as a discussion about the rationale and recent clinical data surrounding the use of ECMO and other forms of mechanical circulatory support for SCM.
脓毒症性心肌病（SCM）是重症监护医学中日益受到关注的问题。它通常表现为左、右或双心室射血分数降低，随后在数天至数周内功能恢复。静脉-动脉体外膜肺氧合（ECMO）已被用于治疗各种病因导致的休克患者，包括心源性和脓毒性休克。本文综述了导致 SCM 的当前病理生理机制，并提供了 SCM 的检测和治疗算法，以及围绕 ECMO 和其他形式的机械循环支持用于 SCM 的原理和最新临床数据的讨论。
