In Vitro Reversal of Cardiac Deterioration in Septic Shock With Tetraethylammonium Chloride

Overwhelming sepsis associated with cardiac failure continues to be a major clinical problem. This is commonly associated with a failure to respond to conventional pharmacologic therapy. This study was undertaken to see if manipulations of the electrophysiologic defects previously described by treatment with tetraethylammonium chloride (TEA) would be advantageous. Septic shock was induced in rabbits by a lethal dose of Escherichia coli. Peak tension and velocities of contraction and relaxation were measured in papillary muscle with and without 5mM TEA. Exposure to this compound improved peak tension and velocities of contraction and relaxation to normal values. The action of TEA is not specific to septic tissue as values in normal muscles are similarly improved. Tetraethylammonium chloride or other drugs that decrease outward potassium current and prolong the action potential duration may be helpful in treating cardiac dysfunction that accompanies sepsis.