G Pilz, P McGinn, P Boekstegers, S Kääb, S Weidenhöfer, K Werdan
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引用次数: 0
摘要
评估假单胞菌(P.)比非P.更严重的心脏抑制实验结果的临床相关性。我们回顾性比较了26例脓毒症患者的血流动力学资料(20例,单一病原体;6例,p阳性培养高于非p阳性培养。非p的102种。脓毒症。与其他研究一样,左室卒中工作指数(LVSWI)用于评估心脏功能。两组(所有数字均为平均值)具有相似的疾病和脓毒症严重程度(p与非p:感染性休克,81%对87%;APACHE II评分,29.1 vs 29.2;Elebute败血症评分,18.1比18.1;死亡率,58% vs. 62%)。预负荷(肺毛细血管楔压15.0 vs 16.3 mm Hg)和全身血管阻力(588 vs 572 dyn.cm-5.sec)具有可比性。心脏功能无显著差异(LVSWI, 42.8 vs. 38.3 g m/m2),这一结果在经培养证实的菌血症、有无既往存在的心血管疾病或感染性休克的亚组中重现。因此,我们的数据表明,假单胞菌脓毒症患者的心血管功能障碍程度与其他同等疾病严重程度的非假单胞菌脓毒症患者相比没有差异。
Pseudomonas sepsis does not cause more severe cardiovascular dysfunction in patients than non-Pseudomonas sepsis.
To evaluate the clinical relevance of the experimental findings of a more severe cardiac depression in Pseudomonas (P.) than in non-P. sepsis, we retrospectively compared the hemodynamic data in 26 patients with P. sepsis (20 cases, single pathogen; six cases, more positive cultures with P. than with non-P. species), and 102 with non-P. sepsis. As in other studies, the left ventricular stroke work index (LVSWI) was used to assess cardiac performance. The two groups (all numbers are means) had a similar disease and sepsis severity profile (P. vs. non-P: septic shock, 81% vs. 87%; APACHE II scores, 29.1 vs. 29.2; Elebute sepsis scores, 18.1 vs. 18.1; mortality, 58% vs. 62%). Preload (pulmonary capillary wedge pressure 15.0 vs. 16.3 mm Hg) and systemic vascular resistance (588 vs 572 dyn.cm-5.sec) were comparable. Cardiac performance displayed no significant difference (LVSWI, 42.8 vs. 38.3 g.m/m2), a result reproduced in the subgroups with culture-proven bacteremia, with or without preexisting cardiovascular disease or septic shock. Thus, our data suggest that there is no difference in the degree of cardiovascular dysfunction in patients with Pseudomonas compared to non-Pseudomonas sepsis of otherwise equivalent disease severity.