CHEST 2023 On Demand Pass-Cutting to the Heart of Sepsis: Cardiac Dysfunction in Sepsis and Septic Shock

Video Transcription

Video Summary

In this presentation, the speakers discuss sepsis cardiomyopathy, a condition characterized by myocardial dysfunction in patients with sepsis. They explain that sepsis cardiomyopathy is a complex condition with different presentations and no clear definition. One challenge in diagnosing sepsis cardiomyopathy is the lack of consensus on the diagnostic criteria. Echocardiography is commonly used to diagnose sepsis cardiomyopathy, but there are limitations to its use. For example, echocardiographic parameters such as ejection fraction and strain can be influenced by loading conditions and may not accurately reflect myocardial function. Biomarkers such as troponin and BNP are commonly elevated in sepsis, but do not provide a clear diagnosis of sepsis cardiomyopathy. The speakers also discuss phenotyping sepsis-induced cardiomyopathy using clustering analysis. They explain that this approach can help identify distinct groups of patients with different echocardiographic manifestations and outcomes. They found that patients with sepsis-induced cardiomyopathy had worse outcomes compared to patients without cardiomyopathy. In terms of treatment, the speakers explain that while there is limited evidence, inotropes may be considered in patients with severe LV systolic dysfunction. They caution that the use of inotropes should be done with caution as they may be associated with higher mortality. They also discuss the use of mechanical circulatory support, such as ECMO, in the setting of sepsis-induced cardiogenic shock. However, they note that more research is needed in this area. Overall, the speakers emphasize the need for individualized management based on the specific characteristics of each patient's sepsis cardiomyopathy.

Meta Tag

Category Critical Care

Session ID 1052

Speaker Siddharth Dugar

Speaker Deepa Gotur

Speaker Michael Lanspa

Speaker Ryota Sato

Track Critical Care

Keywords

sepsis cardiomyopathy

myocardial dysfunction

diagnostic criteria

echocardiography

biomarkers

phenotyping

outcomes

inotropes

mechanical circulatory support

individualized management