Semin Respir Crit Care Med 2011; 32(5): 552-557
DOI: 10.1055/s-0031-1287863
© Thieme Medical Publishers

Organ Failure in the ICU: Cardiac Alterations

Laurent Bodson1 , 2 , Koceila Bouferrache1 , 2 , Mohamed Saleh1 , 2 , Cyril Charron1 , 2 , Antoine Vieillard-Baron1 , 2
  • 1Intensive Care Unit, University Hospital Ambroise Paré, Boulogne, France
  • 2Université de Versailles, Saint Quentin en Yveline, Versailles, France
Further Information

Publication History

Publication Date:
11 October 2011 (online)

ABSTRACT

Cardiac alterations may be defined as changes that lead to abnormal cardiac function. They include decrease in preload, increase in afterload, and depressed cardiac contractility. Cardiac dysfunction differs from cardiac failure: cardiac performance is altered, but this does not necessarily mean that the cardiovascular system is failing. Several tools are available to detect cardiac alterations. Some may continuously assess cardiac performance by mainly or exclusively measuring cardiac output, but no information is given about the mechanisms underlying the cardiac output decrease. Doppler echocardiography allows noncontinuous cardiac monitoring, but it is perfectly adapted to evaluation of cardiac performance. It directly visualizes cardiac contractility and assesses cardiac preload. Only when there is an imbalance between oxygen demand and oxygen transport is correction of cardiac alterations required. But the truth is that no study supports the use of one treatment rather than another. Changes in respiratory settings or in respiratory mechanics induce changes in cardiac function and must then be considered in the strategy.

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Antoine Vieillard-BaronM.D. Ph.D. 

Hôpital Ambroise Paré, Service de Réanimation

9 avenue Charles de Gaulle, 92104 Boulogne, France

Email: antoine.vieillard-baron@apr.aphp.fr