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 m ore severe cardiac depression in Pseudomonas (P.) than in non-P. sepsi s, we retrospectively compared the hemodynamic data in 26 patients wit h P. sepsis (20 cases, single pathogen; six cases, more positive cultu res 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 u sed to assess cardiac performance. The two groups (all numbers are mea ns) had a similar disease and sepsis severity profile (P. vs. non-P: s eptic shock, 81% vs. 87%; APACHE II scores, 29.1 vs. 29.2; Elebute sep sis 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 r esistance (588 vs 572 dyn . cm(-5) . sec) were comparable. Cardiac per formance displayed no significant difference (LVSWI, 42.8 vs. 38.3 g . m/m(2)), a result reproduced in the subgroups with culture-proven bac teremia, with or without preexisting cardiovascular disease or septic shock. Thus, our data suggest that there is no difference in the degre e of cardiovascular dysfunction in patients with Pseudomonas compared to non-Pseudomonas sepsis of otherwise equivalent disease severity. (C ) 1994 Wiley-Liss, Inc.