Daily serial echocardiograms are done on patients with septic shock to evaluate left ventricular size and function. Studies using radionuclide cineangiography and simultaneous hemodynamic measurements have demonstrated a reversible depression of left ventricular ejection fraction associated with left ventricular dilatation. However, because of the risks associated with ionizing radiation, repeated radionuclide studies cannot be performed frequently. Echocardiography is a noninvasive technique that can be performed daily (or more frequently if necessary). By obtaining frequent echocardiograms, the time course of the changes in ventricular size and function that occur in patients with septic shock can be better defined. In addition, regional wall motion abnormalities can be better detected using echocardiography with multiple views than with radionuclide cineagiography using a single view. Serial echocardiography also has demonstrated the same reversible changes in myocardial size and function demonstrated by radionuclide cineangiography, thus confirming these findings by an independent technique.
