Am. J. Respir. Crit. Care Med., Volume 161, Number 4, April 2000, 1087-1093

Cardiac Contractility Is Not Depressed in Early Canine Endotoxic Shock

MICHAEL R. PINSKY and PHILLIPE RICO

Cardiopulmonary Research Laboratory and Department of Anesthesiology and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

We investigated effects of acute endotoxemia (Escherichia coli endotoxin, 1 mg/kg, intravenously) on left ventricular (LV) function in the first 4 h after induction of endotoxic shock in anesthetized canine preparations (n = 7 each, endotoxin and control groups). LV pressure and conductance (volume) catheters were used to construct pressure-volume loops. Transient inferior vena cava occlusion was used to rapidly and reversibly alter LV end-diastolic volume. LV contractility was assessed from the slope of the LV end-systolic pressure-volume relationship (Ees) and from preload-recruitable stroke work (PRSW), and from their change (Ees and PRSW, respectively, measured at 2 and 4 h only), in response to a dobutamine infusion (5 µg/kg/min). Diastolic function and arterial tone were assessed as the maximal negative change in filling pressure versus time (max dP/dt), filling rate, and arterial elastance (Ea), respectively. Ees, PRSW, Ea, diastolic function, and hemodynamics were measured hourly. Endotoxemia induced an immediate hypotensive, hyperdynamic, tachycardic state with progressive lactic acidosis. By 2.5 h after endotoxin infusion, heart rate returned to preendotoxin and control levels, but the other changes remained. However, no change occurred in LV Ees, Ees, PRSW, PRSW, diastolic function, or Ea during the 4-h measurement interval. The cardiovascular collapse seen during the first 4 h of endotoxemia is therefore not due even partly to alterations in LV contractility.

This article has been cited by other articles:

				D. Konrad, M. Haney, G. Johansson, M. Wanecek, E. Weitzberg, and A. Oldner Cardiac effects of endothelin receptor antagonism in endotoxemic pigs Am J Physiol Heart Circ Physiol, August 1, 2007; 293(2): H988 - H996. [Abstract] [Full Text] [PDF]

				A. Kumar, A. Kumar, P. Michael, D. Brabant, A. M. Parissenti, C. V. Ramana, X. Xu, and J. E. Parrillo Human Serum from Patients with Septic Shock Activates Transcription Factors STAT1, IRF1, and NF-{kappa}B and Induces Apoptosis in Human Cardiac Myocytes J. Biol. Chem., December 30, 2005; 280(52): 42619 - 42626. [Abstract] [Full Text] [PDF]

				C. F. Royse and A. G. Royse The Myocardial and Vascular Effects of Bupivacaine, Levobupivacaine, and Ropivacaine Using Pressure Volume Loops Anesth. Analg., September 1, 2005; 101(3): 679 - 687. [Abstract] [Full Text] [PDF]

				E. Aghajani, D. Nordhaug, C. Korvald, T. Steensrud, K. Husnes, O. Ingebretsen, A. Revhaug, and T. Myrmel Mechanoenergetic inefficiency in the septic left ventricle is due to enhanced oxygen requirements for excitation-contraction coupling Cardiovasc Res, August 1, 2004; 63(2): 256 - 263. [Abstract] [Full Text] [PDF]

				M. J. TOBIN Critical Care Medicine in AJRCCM 2000 Am. J. Respir. Crit. Care Med., October 15, 2001; 164(8): 1347 - 1361. [Full Text] [PDF]