Successful treatment of sepsis-induced cardiomyopathy using extracorporeal membrane oxygenation and polymyxin-b endotoxin adsorption
Abstract
Sepsis-induced cardiomyopathy develops as early as the first day in 25–60% of septic patients. It is believed to be caused by circulating endotoxins and cytokins and characterized by enlargement of left ventricle, a decrease in cardiac output and reversibility in favorable conditions within 10 days. In this article a clinical case of a patient with shock development (with elements of cardiogenic and septic shock) after cardiac surgery is considered and we demonstrate new diagnostic and treatment strategies based on clinical and laboratory phenotype determination of sepsis and cardiovascular sys- tem response type to generalized inflammation; selection of life support therapies, including extra- corporeal membrane oxygenation, continuous renal replacement therapies and target therapy with PMX-B endotoxin adsorption.
Keywords:sepsis, sepsis-induced cardiomyopathy, septic shock, sepsis phenotypes, ECMO, PMX hemoperfusion
For citation: Babaev M.A., Shalginskih O.A., Maslennikova M.A., Urbanov A.V., Komnov R.D., Dymova O.V., Eremenko A.A. Successful treatment of sepsis-induced cardiomyopathy using extracorporeal membrane oxygenation and polymyxin-b endotoxin sorbtion. Clin Experiment Surg. Petrovsky J. 2019; 7 (3): 105–17. doi: 10.24411/2308-1198-2019-13012 (in Russian)
Received 25.06.2019. Accepted 25.07.2019.
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