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Fig. 5 | Critical Ultrasound Journal

Fig. 5

From: Echocardiography in the sepsis syndromes

Fig. 5

Sepsis-related myocardial dysfunction. Septic shock in a patient with community-acquired pneumonia (same patient of Fig. 3). Repeated TEE assessments (mid-esophageal 4-chamber views). At ICU admission [SAP 110/70 mmHg, HR 118 bpm, norepinephrine 0.4 mcg/(kg min)] a pattern of severe biventricular dysfunction is detected (Video 5A ESM), as evidenced by a small reduction of both ventricle’s size from end-diastole (a) to end-systole (d); measured EF is 15%, TAPSE 12,9 mm, CO 3,59 L/min. Hemodynamic improvement occurs after epinephrine infusion at [0.1 mcg/(kg min)] (be, Video 5B ESM): SAP 140/76, HR 122 bpm, EF 25%, TAPSE 15.7 mm, CO 4.83 L/min. On day 12 patient is weaned from vasoactive drugs (cf, Video 5C ESM): SAP 130/68, HR 93 bpm, EF 58%, TAPSE 21.1 mm, CO 6.43 L/min. Note that the LV looks dilated in a and b, but only if compared with its size after recovery (c), and not as absolute value (LV EDV = 146 ml, upper range of normality). RA right atrium, RV right ventricle, LA left atrium, LV left ventricle, EF ejection fraction, TAPSE tricuspid annulus plane systolic excursion, CO cardiac output

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