Role of Milrinone in Septic Myocardial Depression

At present, myocardial depression (MD) in septic shock (SS) is more frequently recognized. In 1984, Parker et al. published 20 patients with SS where 50% of them showed a left ventricular ejection fraction (LVEF) less than 40% 1 . It was not until 2006 that it became more widely accepted that some degree of MD was present in this kind of patients 2 . However, the prevalence has been variable depending on the evaluation method, either through cardiac output (CO), measurement of troponins, B type Natriuretic Peptide or by echocardiography 2-4 . In 2008 Vieillard-Baron et al. studied 67 patients with SS without a history of heart disease with transesophageal echocardiography. They estimated a mean incidence of MD greater than 60%, which manifests itself in the first 48 hours of evolution and recovers between seven and ten days after the onset of SS 5 .