Frontiers in Myocardia

Volume: 1

Septic Cardiomyopathy: Quo Vadis? From Past-to-the Future

Author(s): James J. Douglas, John H. Boyd and Keith R. Walley

Pp: 188-212 (25)

DOI: 10.2174/9781681080604115010016

* (Excluding Mailing and Handling)

Abstract

Sepsis remains the most common admission diagnosis to ICU and approximately half of these patients develop some form of cardiac dysfunction. Genetic factors, large vessel and microcirculatory changes, depressant factors, metabolic changes, autonomic dysregulation and a myriad of cellular regulators have all been implicated in the myocardial dysfunction. The cardiomyopathy is reversible may include elements of LV and RV systolic and diastolic dysfunction. Current approaches to treatment include guideline based septic shock therapy often along with inotropic support, however a new approach may include heart rate control.


Keywords: Left ventricular ejection fraction, Sepsis, Septic shock, Ventricular dysfunction

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      • 14. app/Models/UserAccess/UserAccess.php:784
      • 15. middleware::check_user_access:114
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      • 19. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
      • 20. vendor/laravel/framework/src/Illuminate/Routing/Route.php:206
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      • 17. app/Http/Controllers/ChapterController.php:1434
      • 18. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 19. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      980μsalphaeurekaselec_live_10_06_2022Subject.php#238
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      • 14. app/Models/Subject.php:238
      • 15. app/Http/Controllers/ChapterController.php:1434
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      570μsalphaeurekaselec_live_10_06_2022Subject.php#255
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      • 16. app/Models/Subject.php:255
      • 17. app/Http/Controllers/ChapterController.php:1435
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      • 19. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      570μsalphaeurekaselec_live_10_06_2022Subject.php#255
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      • 14. app/Models/Subject.php:255
      • 15. app/Http/Controllers/ChapterController.php:1435
      • 16. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
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      • 17. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      300μsalphaeurekaselec_live_10_06_2022ContentAccess.php#647
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      • 11. app/Models/ContentAccess.php:647
      • 12. app/Http/Controllers/ChapterController.php:1465
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
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      230μsalphaeurekaselec_live_10_06_2022ContentAccess.php#647
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      • 11. app/Models/ContentAccess.php:647
      • 12. app/Http/Controllers/ChapterController.php:1478
      • 13. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 14. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
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      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1518
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 221948497 and j.to_ip >=221948497 )) and ((j.from_date <= 1740422283 and j.to_date >= 1740422283 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7805) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 221948497 and j.to_ip >=221948497 )) and ((j.from_date <= 1740422283 and j.to_date >= 1740422283 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7805) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 221948497 and j.to_ip >=221948497 )) and ((j.from_date <= 1740422283 and j.to_date >= 1740422283 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 7805)
      570μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 1734 and `b`.`banner_from_date` <= 1740422283 and `b`.`banner_to_date` >= 1740422283 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.03msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 1734
      • 3: 1740422283
      • 4: 1740422283
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='17d060debb4a83072968bd7204b78d7e'
      210μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    4Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
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        33FRu9at1sK3LB86szM33hN33oFMMa2WKjzGVywK
        uc_cart_id
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        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7805" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
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        status_code
        200
        
        status_text
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        format
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        content_type
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        request_query
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        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
        array:1 [ "wayfindertarget" => null ]
        response_headers
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        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Mon, 24 Feb 2025 18:38:03 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IklLUlpyZzJkR2IyVXBja0lpbE1mbEE9PSIsInZhbHVlIjoiTnlGSnp3SlhPT0N5R1ROVnlOUEYzWHZ3dnd4NFpLdGg5MVQ2YlVjOC9hNngwYzBYNVFpMkVySGxIN2JBQ2RVSW4yU3B2VTBWc0xyalE3Y0xDaHZ0eDhJc1hJbUJSRVpRVXl4TVVWdDVSTDNPZTFXaVR3Y0JXNGxwMHh3bVBJd3kiLCJtYWMiOiJjNGRmYTM2ZWYwNjAwZDY0ZmVmN2Y1NmJkOGRiMjVlOTUwYmU1N2YzYzc2OTU2YTJkOTQyZmZjZWJlM2ZiYWViIiwidGFnIjoiIn0%3D; expires=Thu, 27 Feb 2025 06:38:03 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IklLUlpyZzJkR2IyVXBja0lpbE1mbEE9PSIsInZhbHVlIjoiTnlGSnp3SlhPT0N5R1ROVnlOUEYzWHZ3dnd4NFpLdGg5MVQ2YlVjOC9hNngwYzBYNVFpMkVySGxIN2JBQ2RVSW4yU3B2V" 1 => "alphaeurekaselectnet_session=eyJpdiI6ImlTaDlXY0lxM0xEQXZWL0szUTVwWFE9PSIsInZhbHVlIjoiRmRQaXJwdmVmM2JLUG5yRGs1V1NwdFBocmxVeERBenVRdzRzU3Z5bUZlUHlqYlh3d3RTZTBNaDBrQmowV3hNZys4V21SVFI0dGFHWDZHTUI2c1o2cVhFcXhMa0NWTHdzbnBHaS9mU1QzcWN5TU5peHYyTU4wcVVzSVJWRTFld2siLCJtYWMiOiIwZjM2YjAxYTBjNTkwNjYzZGI4MDQxMWViMmJmMWQ2ODBhM2Y3ZTJhZDM5ZDUxMmJhMTU2MTU4ZTVlZDMyZWY2IiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6ImlTaDlXY0lxM0xEQXZWL0szUTVwWFE9PSIsInZhbHVlIjoiRmRQaXJwdmVmM2JLUG5yRGs1V1NwdFBocmxVeERBenVRdzRzU3Z5bUZlUHlqYlh3d3RTZTBNaDB" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IklLUlpyZzJkR2IyVXBja0lpbE1mbEE9PSIsInZhbHVlIjoiTnlGSnp3SlhPT0N5R1ROVnlOUEYzWHZ3dnd4NFpLdGg5MVQ2YlVjOC9hNngwYzBYNVFpMkVySGxIN2JBQ2RVSW4yU3B2VTBWc0xyalE3Y0xDaHZ0eDhJc1hJbUJSRVpRVXl4TVVWdDVSTDNPZTFXaVR3Y0JXNGxwMHh3bVBJd3kiLCJtYWMiOiJjNGRmYTM2ZWYwNjAwZDY0ZmVmN2Y1NmJkOGRiMjVlOTUwYmU1N2YzYzc2OTU2YTJkOTQyZmZjZWJlM2ZiYWViIiwidGFnIjoiIn0%3D; expires=Thu, 27-Feb-2025 06:38:03 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IklLUlpyZzJkR2IyVXBja0lpbE1mbEE9PSIsInZhbHVlIjoiTnlGSnp3SlhPT0N5R1ROVnlOUEYzWHZ3dnd4NFpLdGg5MVQ2YlVjOC9hNngwYzBYNVFpMkVySGxIN2JBQ2RVSW4yU3B2V" 1 => "alphaeurekaselectnet_session=eyJpdiI6ImlTaDlXY0lxM0xEQXZWL0szUTVwWFE9PSIsInZhbHVlIjoiRmRQaXJwdmVmM2JLUG5yRGs1V1NwdFBocmxVeERBenVRdzRzU3Z5bUZlUHlqYlh3d3RTZTBNaDBrQmowV3hNZys4V21SVFI0dGFHWDZHTUI2c1o2cVhFcXhMa0NWTHdzbnBHaS9mU1QzcWN5TU5peHYyTU4wcVVzSVJWRTFld2siLCJtYWMiOiIwZjM2YjAxYTBjNTkwNjYzZGI4MDQxMWViMmJmMWQ2ODBhM2Y3ZTJhZDM5ZDUxMmJhMTU2MTU4ZTVlZDMyZWY2IiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6ImlTaDlXY0lxM0xEQXZWL0szUTVwWFE9PSIsInZhbHVlIjoiRmRQaXJwdmVmM2JLUG5yRGs1V1NwdFBocmxVeERBenVRdzRzU3Z5bUZlUHlqYlh3d3RTZTBNaDB" ] ]
        session_attributes
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        array:5 [ "_token" => "33FRu9at1sK3LB86szM33hN33oFMMa2WKjzGVywK" "uc_cart_id" => "17d060debb4a83072968bd7204b78d7e" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/7805" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-24 18:38:03GET/chapter/7805112196