• Clinics in chest medicine · Dec 2008

    Review

    The right ventricle in sepsis.

    • Chee M Chan and James R Klinger.
    • Division of Pulmonary and Critical Care Medicine, Washington Hospital Center, 110 Irving Street NW #2B-39, Washington, DC 20010, USA. chee.m.chan@medstar.net
    • Clin. Chest Med. 2008 Dec 1; 29 (4): 661-76, ix.

    AbstractRight ventricular dysfunction is common in sepsis and septic shock because of decreased myocardial contractility and elevated pulmonary vascular resistance despite a concomitant decrease in systemic vascular resistance. The mainstay of treatment for acute right heart failure includes treating the underlying cause of sepsis and reversing circulatory shock to maintain tissue perfusion and oxygen delivery. Decreasing pulmonary vascular resistance with selective pulmonary vasodilators is a reasonable approach to improving cardiac output in septic patients with right ventricular dysfunction. Treatment for right ventricular dysfunction in the setting of sepsis should concentrate on fluid repletion, monitoring for signs of RV overload, and correction of reversible causes of elevated pulmonary vascular resistance, such as hypoxia, acidosis, and lung hyperinflation.

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