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Cardiorespiratory patterns in viral septicemia
D G Okrent1, E Abraham, D Winston
1Division of Pulmonary and Critical Care Medicine, UCLA Center for the Health Sciences.
The American Journal of Medicine
|October 1, 1987
Summary
Viral infections can cause septic shock with a high cardiac output and low systemic vascular resistance. Unlike bacterial shock, viral septic shock shows normal pulmonary vascular resistance, sparing the lungs.
Area of Science:
- Critical Care Medicine
- Infectious Diseases
- Cardiology
Background:
- Viral infections can lead to hypotension and shock.
- The specific cardiorespiratory patterns in viral septic shock remain undescribed.
- Cytomegalovirus (CMV) sepsis is a severe form of viral infection.
Purpose of the Study:
- To describe the cardiorespiratory patterns in patients with fatal cytomegalovirus sepsis.
- To compare the hemodynamic profile of viral septic shock with bacterial sepsis.
Main Methods:
- Retrospective review of the clinical course of nine patients who died from overwhelming cytomegalovirus sepsis.
- Analysis of cardiorespiratory parameters including cardiac index, systemic vascular resistance index (SVRI), and pulmonary vascular resistance index (PVRI).
Main Results:
- Viral septicemia was characterized by an increased cardiac index and elevated oxygen delivery.
- A decreased systemic vascular resistance index (SVRI) was observed, indicating a low peripheral resistance state.
- Pulmonary vascular resistance index (PVRI) remained normal, distinguishing it from bacterial sepsis and endotoxemia.
Conclusions:
- Overwhelming viral infections, such as CMV sepsis, can induce a high-output, low-flow shock state.
- The relative preservation of pulmonary circulation in viral shock may be due to the absence of endotoxemia.
- These findings highlight distinct hemodynamic patterns in viral versus bacterial septic shock.