Perret C, Depeursinge F
Schweiz Med Wochenschr. 1981 Nov 21;111(47):1799-803.
Septic shock is known to induce progressive myocardial dysfunction characterized hemodynamically by a decrease in cardiac output and a rise in ventricular filling pressures. Both ventricles are affected. Benefit from inotropic agents is inconsistent. Identification of the factors responsible for the progressive cardiac deterioration is rendered difficult by the complexity of clinical situations. Experimental models demonstrate a progressive inhibition of contractility. Several arguments suggest the possible role of interstitial myocardial edema in altering the microcirculation, decreasing substrate delivery and diminishing ventricular compliance. The role of a myocardial depressant factor has still to be demonstrated.
已知脓毒性休克会导致进行性心肌功能障碍，其血流动力学特征为心输出量减少和心室充盈压升高。两个心室均会受到影响。使用正性肌力药物的获益并不一致。由于临床情况复杂，确定导致心脏进行性恶化的因素变得困难。实验模型显示收缩力逐渐受到抑制。有几个论据表明，心肌间质水肿可能在改变微循环、减少底物供应和降低心室顺应性方面发挥作用。心肌抑制因子的作用仍有待证实。
