Hemodynamic responses to gram-positive versus gram-negative sepsis in critically ill patients with and without circulatory shock.

Abstract

To examine the hemodynamic patterns of critically ill patients with septicemia to evaluate their relationship to blood bacteriology. Retrospective study. Medical ICUs of a tertiary care medical center. Total of 59 critically ill patients with bacteremia: 33 with Gram-positive and 26 with Gram-negative bacteremia. Hemodynamic variables and mixed venous oxygen saturation (SvO2) measurements associated with the highest cardiac index measured within 72 hrs of positive blood cultures. No significant differences in cardiac index, mean arterial pressure, systemic vascular resistance, oxygen extraction ratio, or SvO2 were observed comparing the two groups. We were unable to demonstrate clinically important differences between the hemodynamic responses to Gram-positive vs. Gram-negative sepsis.