[Hemodynamic differences do not exist in patients with adult respiratory syndrome with or without infection]

To verify whether patients with adult respiratory distress syndrome (ARDS), associated to sepsis or not, may be differentiated according to the values of the hemodynamic variables.

Thirty-two consecutive patients with ARDS admitted to an intensive care unit over a period of 32 months were prospectively studied. In 18 patients ARDS was associated to sepsis. The value of the hemodynamic variables were compared between both groups of patients (18 with sepsis and 14 without) within the first 24 hours of diagnosis of the syndrome.

Mortality of patients with ARDS associated with sepsis was greater than in those without sepsis (78% vs 57%). In general both groups of patients with ARDS presented similar values of pulmonary hypertension (28 +/- 6 and 25 +/- 4 mmHg) with elevated pulmonary vascular resistance, and with an above normal cardiac index and ventricular function parameters. No significant differences were found in hemodynamic values, ventricular function and oxygen transport among patients with ARDS, with or without sepsis, or among survival or death in each group, or those considered in general.

This study demonstrated that patients with the septic adult respiratory distress syndrome (ARDS) have the same hemodynamic changes as those observed in patients with ARDS without sepsis. This absence of differences may be explained by the presence of mechanisms common in sepsis and ARDS.