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Richard H. Carmona, MD; Tanny Tsao, MS; Michael Dae, MD; Donald D. Trunkey, MD

Arch Surg. 1985;120(1):30-35.

Abstract
• Myocardial depression is a major but poorly understood component of septic shock. This study investigates the morphologic and biochemical abnormalities associated with septic shock. Myocardial cells are incubated in normal and septic plasma in a nutrient-, oxygen-, pH-, electrolyte-, and temperature-controlled environment. Cells and media are tested for basal- and epinephrine-stimulated cyclic adenosine monophosphate (cAMP), lactic dehydrogenase (LDH), and creatine kinase. Electron microscopic studies are done at the end of incubation. Septic LDH and creatine kinase levels in the media are increased substantially, and septic cAMP levels are reduced significantly. Septic cells beat irregularly and arrest along with exhibiting abnormal electron microscopic structure. Septic myocardial dysfunction occurs independently of previously postulated causes that are controlled for in this experiment and therefore may be due to endogenously produced or accumulated toxic factor(s).

(Arch Surg 1985;120:30-35)

Author Affiliations
From the Department of Surgery, University of California San Francisco at San Francisco General Hospital.

Footnotes
Accepted for publication Aug 22, 1984.

Read before the Fourth Annual Meeting of the Surgical Infection Society, Montreal, April 23, 1984.

Reprint requests to Department of Surgery, San Francisco General Hospital, 1001 Potrero Ave, San Francisco, CA 94110 (Dr Carmona).

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