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Sequential cardiorespiratory patterns in septic shock.

E Abraham, W C Shoemaker, R D Bland

    Critical Care Medicine
    |October 1, 1983
    PubMed
    Summary
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    Early cardiorespiratory changes precede septic shock's hypotensive crisis. Monitoring reveals altered oxygen transport and flow maldistribution as key early events in septic shock progression.

    Area of Science:

    • Critical Care Medicine
    • Cardiovascular Physiology
    • Hemodynamics

    Background:

    • Septic shock is characterized by hypotension and circulatory dysfunction.
    • Understanding the temporal sequence of physiological events is crucial for timely intervention.

    Purpose of the Study:

    • To define the temporal pattern of hemodynamic and oxygen transport alterations in septic shock.
    • To identify early cardiorespiratory changes preceding the hypotensive crisis.

    Main Methods:

    • Sequential hemodynamic and oxygen transport monitoring in 33 septic shock patients.
    • Comparison of measurements during the 24 hours before and 48 hours after the hypotensive crisis (lowest mean arterial pressure).

    Main Results:

    Related Experiment Videos

  • Pre-crisis: Increased cardiac index (CI), pressures (CVP, WP), and pulmonary vascular resistance index (PVRI); decreased mean arterial pressure (MAP), systemic vascular resistance index (SVRI), and oxygen delivery (Do2).
  • Transiently low oxygen consumption (VO2) occurred 12 hours before and at the crisis.
  • Post-crisis: Persistently elevated CI, pressures, and PVRI; reduced MAP, SVRI, Do2, and VO2.

    • Conclusions:

    • Antecedent cardiorespiratory alterations precede the hypotensive episode in septic shock.
    • Systemic circulation flow maldistribution is an early event with potential pathogenic significance in septic shock.