title: The role of cardiac dysfunction in multiorgan dysfunction.
abstract: OBJECTIVE
  The aim of this review was to examine the main determinants of cardiac dysfunction in critically ill patients, as well as how a reduction in cardiac performance influences other organ function.
  
  
  RESULTS
  Cardiac dysfunction is a frequent complication in critically ill patients and contributes to organ hypoperfusion and poor outcome. Pathophysiological determinants may include a primary ischaemia/reperfusion injury of the heart, effects of systemic inflammatory and adrenergic responses of the body to a variety of acute insults, as well as cardiovascular effects of commonly applied intensive respiratory or haemodynamic treatments. A strict connection exists between cardiac and other organ function, mediated by haemodynamic, humoral, and immune mechanisms. Heart, lungs, kidneys, and other splanchnic organs such as gut and liver influence each other function in a bidirectional way: this organ crosstalk must be regarded as a key aspect in multiorgan dysfunction.
  
  
  CONCLUSIONS
  The heart should never be regarded as an isolated organ. When dealing with cardiac dysfunction, clinicians must consider the underlying pathophysiology, potential myocardial depressant effects of intensive treatments, and the complex interaction with other organ function.
authors.affiliation: Anaesthesia and Intensive Care Unit, Department of Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy.
authors.forename: Abele
authors.initials: A
authors.lastname: Donati
authors.forename: Andrea
authors.initials: A
authors.lastname: Carsetti
authors.forename: Elisa
authors.initials: E
authors.lastname: Damiani
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000627:therapeutic use; D002302:Cardiac Output; D002395:Catecholamines / Q000009:adverse effects / Q000097:blood; D016638:Critical Illness / Q000628:therapy; D041981:Gastrointestinal Tract / Q000098:blood supply / Q000503:physiopathology; D006321:Heart / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000098:blood supply / Q000503:physiopathology; D008168:Lung / Q000098:blood supply / Q000503:physiopathology; D009102:Multiple Organ Failure / Q000503:physiopathology*; D017202:Myocardial Ischemia / Q000150:complications / Q000209:etiology; D015427:Reperfusion Injury / Q000209:etiology; D013312:Stress, Physiological; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications / Q000209:etiology / Q000378:metabolism
chemical_list: D000316:Adrenergic alpha-Agonists; D002395:Catecholamines