Plasma beta-endorphin-like-immunoreactivity levels and hemodynamics in patients with septic shock

Plasma beta-endorphin-like immunoreactivity (beta-ELIR) levels were measured during hyper and hypodynamic phases of septic shock in patients (n = 36) due to a variety of microorganisms. Plasma beta-ELIR levels were elevated in all groups, but were most marked in patients with hyperdynamic circulation due to gram-positive and gram-negative organisms, followed by hypodynamic circulation due to gram-negative organisms and were least elevated in hypodynamic shock due to gram-positive organisms. There was strong correlation between plasma beta-ELIR levels and cardiac index in patients with a hyperdynamic circulation (gram-negative organisms, rs = 0.79, p less than 0.01; gram-positive, rs = 0.85, p less than 0.01) but little to no correlation in patients with hypodynamic circulation (gram-negative, rs = 0.32, p = NS; gram-positive organisms rs = 0.04, p = NS). These results imply that plasma beta-ELIR levels may be involved in the early phases of septic shock and may contribute to a hyperdynamic circulation, whereas plasma beta-ELIR levels may be normal or may not be related to hypodynamic circulation as seen in later phases of shock.