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 car e medical and surgical intensive care unit, university hospital. Patie nts: Eighteen septic (survivors, n = 8; nonsurvivors, n = 10) and 14 n onseptic (survivors, n = 7; nonsurvivors, n = 7) patients studied with in 24 hrs of the diagnosis of ARDS. Interventions: Simultaneous hemody namic, radionuclide cineangiographic, and oxygen delivery and consumpt ion 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 eject ion fractions, end-diastolic volumes, and oxygen delivery and consumpt ion between septic and nonseptic patients. Conclusions: Early in the c ourse of ARDS, there were no differences in hemodynamics, ventricular function, and oxygen delivery and consumption between septic and nonse ptic patients. Sepsis does not account for the previously reported dif ferences in hemodynamics, ventricular function, and oxygen delivery an d oxygen consumption between survivors and nonsurvivors of ARDS. We sp eculate that both ARDS and sepsis cause release of mediators which cau se similar changes in hemodynamics, ventricular function, and oxygen d elivery and consumption.