Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

The role of cardiac dysfunction in multiorgan dysfunction

Donati, Abele; Carsetti, Andrea; Damiani, Elisa

Current Opinion in Anaesthesiology: April 2016 - Volume 29 - Issue 2 - p 172–177
doi: 10.1097/ACO.0000000000000296
INTENSIVE CARE AND RESUSCITATION: Edited by Gernot Marx
Buy

Purpose of review The aim of this review was to examine the main determinants of cardiac dysfunction in critically ill patients, as well as how a reduction in cardiac performance influences other organ function.

Recent findings Cardiac dysfunction is a frequent complication in critically ill patients and contributes to organ hypoperfusion and poor outcome. Pathophysiological determinants may include a primary ischaemia/reperfusion injury of the heart, effects of systemic inflammatory and adrenergic responses of the body to a variety of acute insults, as well as cardiovascular effects of commonly applied intensive respiratory or haemodynamic treatments. A strict connection exists between cardiac and other organ function, mediated by haemodynamic, humoral, and immune mechanisms. Heart, lungs, kidneys, and other splanchnic organs such as gut and liver influence each other function in a bidirectional way: this organ crosstalk must be regarded as a key aspect in multiorgan dysfunction.

Summary The heart should never be regarded as an isolated organ. When dealing with cardiac dysfunction, clinicians must consider the underlying pathophysiology, potential myocardial depressant effects of intensive treatments, and the complex interaction with other organ function.

Anaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy

Correspondence to Professor Abele Donati, Anaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, via Tronto 10/a, 60126, Ancona, Italy. Tel: +390715964603; fax: +390715964601; e-mail: a.donati@univpm.it

Copyright © 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.