Septic Shock pp 129-138 | Cite as

Myocardial Depressant Substances in Septic Shock

  • U. Haglund
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 4)


Cardiac performance is impaired in septic shock. This is not only a terminal event in the hypodynamic phase of septic shock but has also been reported frequently during the hyperdynamic phase (high output failure) or an intermediate phase preceding low output failure and cardiac decompensation. Since depressed cardiac performance was first demonstrated as a consequence of septic shock more than 20 years ago by Solis and Dowing [1], it has been demonstrated frequently in experimental septic shock (see e.g. [1–7] and in clinical septic states [8–13].


Septic Shock Mean Arterial Blood Pressure Circ Shock Myocardial Depressant Superior Mesenteric Artery Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Solis RT, Downing SE (1966) Effects of E. coli endotoxemia on ventricular performance. Am J Physiol 21L307–313Google Scholar
  2. 2.
    Postel J, Schloerb PR (1977) Cardiac depression in bacteremia. Ann Surg 186: 74–82PubMedCrossRefGoogle Scholar
  3. 3.
    Hinshaw LB (1979) Myocardial function in endotoxin shock. Circ Shock Suppl 1: 43–51PubMedGoogle Scholar
  4. 4.
    Falk A, Myrvold HE, Haglund U (1982) Cardiopulmonary function as related to intestinal mucosal lesions in experimental septic shock. Circ Shock 9: 419–432PubMedGoogle Scholar
  5. 5.
    McDonough KH, Lang CH, Spitzer JJ (1984) Depressed function of isolated hearts from hyperdynamic septic rats. Circ Shock 12: 241–251PubMedGoogle Scholar
  6. 6.
    Archer L (1985) Myocardial dysfunction in endotoxin and E.coli-induced shock: pathophysiological mechanisms. Circ Shock 15: 261–280PubMedGoogle Scholar
  7. 7.
    Schneider AJ, Teule GJJ, Kester ADM, Heidendal GAK, Thijs LG (1986) Biventricular function during volume loading in porcine E.coli septic shock, with emphasis on right ventricular function. Circ Shock 18: 53–63PubMedGoogle Scholar
  8. 8.
    Siegel JH, Greenspan M, Del Guercio LRM (1967) Abnormal vascular tone, defective oxygen transport and myocardial failure in human septic shock. Ann Surg 165: 504–517PubMedCrossRefGoogle Scholar
  9. 9.
    Clowes GHA, O’Donnell TF, Ryan NT, Blackburn GL (1974) Energy metabolism in sepsis: treatment based on different patterns in shock and high output stage. Ann Surg 179: 684–694PubMedCrossRefGoogle Scholar
  10. 10.
    Weisul JP, O’Donnell TF, Stone MA, Clowes GHA, Jr (1975) Myocardial performance in clinical septic shock. J Surg Res 18: 357–363PubMedCrossRefGoogle Scholar
  11. 11.
    Weisel RD, Vito L, Dennis RD, Valeri CR, Hechtman HG (1977) Myocardial depression during sepsis. Am J Surg 133: 512–521PubMedCrossRefGoogle Scholar
  12. 12.
    Siegel JH, Giovannini I, Coleman B (1979) Ventilation: perfusion maldistribution secondary to the hyperdynamic cardiovascular state as the major cause of increased pulmonary shunting in human sepsis. J Trauma 19: 432–460PubMedCrossRefGoogle Scholar
  13. 13.
    Sibbald WJ (1985) Myocardial function in the critically ill: factors influencing left and right ventricular performance in patients with sepsis and trauma. Surg Clin North Am 65: 867–893PubMedGoogle Scholar
  14. 14.
    Goldfarb RD (1985) Evaluation of ventricular performance in shock. Circ Shock 15: 281–301PubMedGoogle Scholar
  15. 15.
    Lefer AM (1973) Blood-borne humoral factors in the pathophysiology of circulatory shock. Circ Res 32: 129–139PubMedGoogle Scholar
  16. 16.
    Goldfarb RD (1979) Characteristics of shock-induced circulating cardiodepressant substances: a brief review. Circ Shock 1: 23–33Google Scholar
  17. 17.
    Haglund U (1983) Shock Toxins. In: Altura BM, Lefer AM, Schumer W (eds) Handbook of shock and trauma, vol. I. Basic Science. Raven Press, New York, pp 377–390Google Scholar
  18. 18.
    Brand ED, Lefer AM (1966) Myocardial depressant factor in plasma from cats in irreversible post-oligemic shock. Proc Soc Exp Biol Med 122: 200–203PubMedGoogle Scholar
  19. 19.
    Lefer AM, Glenn TM (1972) Role of the pancreas in the pathogenesis of circulatory shock. In: Hinshaw LB, Cox BG (eds) The fundamental mechanisms of shock. Plenum Publishing, New York, pp 311–335Google Scholar
  20. 20.
    Lefer AM (1978) Properties of cardioinhibitory factors produced in shock. Fed Proc 37: 2734–2740PubMedGoogle Scholar
  21. 21.
    Greene LJ, Shapanka R, Glenn TM, Lefer AM (1977) Isolation of a myocardial depressant factor from plasma of dogs in hemorrhagic shock. Biochim Biophys Acta 491: 275–285PubMedGoogle Scholar
  22. 22.
    Wangensteen SL, Ramey WG, Ferguson WW, Starling JR (1973) Plasma myocardial depressant activity (shock factor) identified as salt in the cat papillary muscle bioassay system. J Trauma 13: 181–194PubMedCrossRefGoogle Scholar
  23. 23.
    Leffler JN, Litvin Y, Barenholz Y, Lefer AM (1973) Proteolysis in formation of a myocardial depressant factor during shock. Am J Physiol 224: 824–831PubMedGoogle Scholar
  24. 24.
    Hallström S, Vogl C, Krösl P, Redl H, Schlag G, Boltzman L (1986) The occurrence of low molecular weight inotropic plasma factors in severe hypovolemic traumatic shock. Circ Shock 19:116, 5-33Google Scholar
  25. 25.
    McConn R, Greineder JK, Wassermann F, Clowes GHA Jr (1979) Is there a humoral factor which depresses ventricular function in sepsis? Circ Shock Suppl 1: 9–22PubMedGoogle Scholar
  26. 26.
    Maksad AK, Cha C-J, Stuart RC, Brosco FA, Clowes GHA Jr (1979) Myocardial depression in septic shock: physiological and metabolic effects of a plasma factor on an isolated heart. Circ Shock Suppl 1: 35–42PubMedGoogle Scholar
  27. 27.
    Hinshaw LB, Greenfield LJ, Owen SE, Archer LT, Guenter CA (1972) Cardiac response to circulating factors in endotoxin shock. Am J Physiol 222: 1047–1053PubMedGoogle Scholar
  28. 28.
    Carli A, Auclair MC, Bleichner G, Weber S, Oechat P, Monsallier JF (1978) Inhibited response to isoproterenol and altered action potential of beating rat heart cells by human serum in septic shock. Circ Shock 5: 85–94PubMedGoogle Scholar
  29. 29.
    Carli A, Auclair MC, Vernimmen C, Jourdon P (1979) Reversal by calcium of rat heart cell dysfunction induced by human sera in septic shock. Circ Shock 6: 147–157PubMedGoogle Scholar
  30. 30.
    Carli A, Auclair MC, Benassayag C, Nunez E (1981) Evidence for an early lipid soluble cardiodepressant factor in rat serum after a sublethal dose of endotoxin. Circ Shock 8: 301–312PubMedGoogle Scholar
  31. 31.
    Parrillo JE, Burch C, Shelhamer JH, Parker MM, Natanson C, Schuette W (1985) A circulating myocardial depressant substance in humans with septic shock. J Clin Invest 76: 1539–1553PubMedCrossRefGoogle Scholar
  32. 32.
    Haglund U, Jodal M, Lundgren O (1984) The small bowel in arterial hypotension and shock. In: Shepherd AP, Granger DN (eds) Physiology of the intestinal circulation. Raven Press, New York, pp 305–319Google Scholar
  33. 33.
    Haglund U, Lundgren O (1973) Cardiovascular effects of blood borne material released from the cat small intestine during simulated shock conditions. Acta Physiol Scand 89: 558–570PubMedCrossRefGoogle Scholar
  34. 34.
    Lundgren O, Haglund U, Isaksson O, Abe T (1976) Effects on myocardial contractility of blood borne material released from the feline small intestine in simulated shock. Circ Res 38: 307–315PubMedGoogle Scholar
  35. 35.
    Haglund U, Myrvold H, Lundgren 0 (1978) Cardiac and pulmonary function in regional intestinal shock. Arch Surg 113: 963–969Google Scholar
  36. 36.
    Lundgren O, Haglund U (1978) On the chemical nature of the blood borne cardiotoxic material released from the feline small bowel in regional shock. Acta Physiol Scand 103: 59–70PubMedCrossRefGoogle Scholar
  37. 37.
    Carrico CJ, Meakins JL, Marshall JC, Fry D, Maier RV (1986) Multiple-organ-failure syndrome. Arch Surg 121: 196–208PubMedGoogle Scholar
  38. 38.
    Haglund U, Lundgren 0 (1978) Intestinal ischemia and shock factors. Fed Proc 37: 2729–2733Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1987

Authors and Affiliations

  • U. Haglund

There are no affiliations available

Personalised recommendations