SeverePneumocystis cariniipneumonia produces a hyperdynamic profile similar to bacterial pneumonia with sepsis

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Abstract

Objectives:

To investigate the effects ofPneumocystis cariniion the cardiovascular system. To compare the hemodynamic data from patients withP. cariniipneumonia with those data from patients with bacterial pneumonia with sepsis.

Design:

Retrospective, descriptive study of prospectively gathered hemodynamic and clinical data.

Setting:

Tertiary referral hospital, medical intensive care unit.

Patients:

Forty-one consecutive patients with severe P.cariniipneumonia and 31 patients with bacterial pneumonia who had invasive hemodynamic monitoring for management of hypotension and/or hypoxemia.

Measurements and Main Results:

On initial presentation, both groups had a hyperdynamic hemodynamic profile that included tachycardia, an increased cardiac index, and a low systemic vascular resistance index. The mean heart rate of theP. cariniipneumonia patients (113 ± 3 beats/min) was significantly lower than that of the patients with bacterial pneumonia (126 ± 4 beats/min). The cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, and pulmonary artery pressures did not differ significantly between the two groups. The patients with bacterial pneumonia had a significantly lower mean left ventricular stroke volume index and stroke work index than the patients with P.cariniipneumonia.

Measurements and Main Results:

Conclusion: P. cariniican produce a hyperdynamic hemodynamic profile similar to that seen in patients with bacterial pneumonia with sepsis. (Crit Care Med 1994; 22:50-54)

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