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RIGHT VENTRICULAR DYSFUNCTION IN SEPSIS: AN UPDATED NARRATIVE REVIEW

Journal

SHOCK
Volume 59, Issue 6, Pages 829-837

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/SHK.0000000000002120

Keywords

Right ventricular dysfunction; sepsis; septic shock; septic cardiomyopathy; echocardiography; biomarkers; ARDS-acute respiratory distress syndrome; ASE-American Society of Echocardiography; BNP-B-type natriuretic peptide; hs-cTnT-high sensitivity TnT; LV-left ventricle; MB-methylene blue; NO-nitric oxide; RV-right ventricle; SCM-septic cardiomyopathy; SOFA-Sequential Organ Failure Assessment; SSC-Surviving Sepsis Campaign; STE-speckle tracking echocardiography

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Sepsis is a significant public health challenge, with high morbidity and mortality. It affects the cardiovascular system, including the reversible dysfunction of one or both ventricles. There is limited research on the impact of right ventricle dysfunction and its biomarkers in sepsis.
Sepsis is a multisystem disease process, which constitutes a significant public health challenge and is associated with high morbidity and mortality. Among other systems, sepsis is known to affect the cardiovascular system, which may manifest as myocardial injury, arrhythmias, refractory shock, and/or septic cardiomyopathy. Septic cardiomyopathy is defined as the reversible systolic and/or diastolic dysfunction of one or both ventricles. Left ventricle dysfunction has been extensively studied in the past, and its prognostic role in patients with sepsis is well documented. However, there is relatively scarce literature on right ventricle (RV) dysfunction and its role. Given the importance of timely detection of septic cardiomyopathy and its bearing on prognosis of patients, the role of RV dysfunction has come into renewed focus. Hence, through this review, we sought to describe the pathophysiology of RV dysfunction in sepsis and what have we learnt so far about its multifactorial nature. We also elucidate the roles of different biomarkers for its detection and prognosis, along with appropriate management of such patient population.

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