No differences in hemodynamics, ventricular function, and oxygen delivery in septic and nonseptic patients with the adult respiratory distress syndrome.

OBJECTIVE

To determine whether there are differences in hemodynamics, ventricular function, oxygen delivery, and oxygen consumption between septic and nonseptic patients who have the adult respiratory distress syndrome (ARDS).

DESIGN

Cohort analytic study.

SETTING

Tertiary care medical and surgical intensive care unit, university hospital.

PATIENTS: Eighteen septic (survivors, n = 8; nonsurvivors, n = 10) and 14 nonseptic (survivors, n = 7; nonsurvivors, n = 7) patients studied within 24 hrs of the diagnosis of ARDS.

INTERVENTIONS: Simultaneous hemodynamic, radionuclide cineangiographic, and oxygen delivery and consumption measurements.

MEASUREMENTS AND MAIN

RESULTS

Cardiac index, right and left ventricular ejection fractions, end-diastolic volume indices, oxygen delivery, and oxygen consumption were measured. There were no differences in mean systemic and pulmonary arterial pressures, cardiac index, systemic vascular resistance, right and left ventricular ejection fractions, end-diastolic volumes, and oxygen delivery and consumption between septic and nonseptic patients.

CONCLUSIONS

Early in the course of ARDS, there were no differences in hemodynamics, ventricular function, and oxygen delivery and consumption between septic and nonseptic patients. Sepsis does not account for the previously reported differences in hemodynamics, ventricular function, and oxygen delivery and oxygen consumption between survivors and non-survivors of ARDS. We speculate that both ARDS and sepsis cause release of mediators which cause similar changes in hemodynamics, ventricular function, and oxygen delivery and consumption.