Parker M M, Shelhamer J H, Bacharach S L, Green M V, Natanson C, Frederick T M, Damske B A, Parrillo J E
Ann Intern Med. 1984 Apr;100(4):483-90. doi: 10.7326/0003-4819-100-4-483.
To characterize the role of cardiac function in septic shock, serial radionuclide cineangiographic and hemodynamic evaluations were done on 20 patients with documented septic shock. Although all patients had a normal or elevated cardiac index, 10 patients had moderate to severe depression of their ejection fraction with values below 0.40. Thirteen of twenty patients survived their episode. Paradoxically, 10 of 13 survivors, but none of the 7 nonsurvivors, had an initial ejection fraction less than 0.40 (p less than 0.005). The mean initial ejection fraction for the survivors was 0.32 +/- 0.04, and their mean end systolic and end diastolic ventricular volumes were substantially increased with a normal stroke volume. The survivors' serial scans showed a gradual return to normal ejection fraction and ventricular volume by 10 days after the onset of shock. Nonsurvivors had normal initial ejection fractions and ventricular volumes that did not change during serial studies.
为了明确心功能在感染性休克中的作用，我们对20例确诊为感染性休克的患者进行了系列放射性核素心血管造影和血流动力学评估。尽管所有患者的心指数正常或升高，但10例患者的射血分数中度至重度降低，数值低于0.40。20例患者中有13例度过了急性期。矛盾的是，13例幸存者中有10例初始射血分数低于0.40，而7例非幸存者中无一例如此（p<0.005）。幸存者的平均初始射血分数为0.32±0.04，其平均收缩末期和舒张末期心室容积显著增加，而每搏量正常。幸存者的系列扫描显示，休克发作后10天时射血分数和心室容积逐渐恢复正常。非幸存者的初始射血分数和心室容积正常，在系列研究过程中没有变化。
