Hyperkinetic shock in viral and pneumococcal pneumonias

Ten patients, suffering from severe viral or bacterial pneumonia had circulatory shock, characterised haemodynamically by normal or high cardiac output (CI = 4.1 +/- 1.2 1/min/m2) and low systemic resistance (SVR = 14 +/- 3.7 mm Hg/1/min/m2). Existence of such a hyperkinetic state greatly complicate...

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Published inIntensive care medicine Vol. 5; no. 2; p. 59
Main Authors Dussan, J, Regnier, B, Darragon, T, Teisseire, B, Le Gall, J R, Lemaire, F
Format Journal Article
LanguageEnglish
Published United States 01.05.1979
Subjects
Adult
Aged
Blood Gas Analysis
Hemodynamics
Humans
Middle Aged
Pneumonia, Pneumococcal - physiopathology
Pneumonia, Pneumococcal - therapy
Pneumonia, Viral - physiopathology
Pneumonia, Viral - therapy
Shock, Septic - physiopathology
Shock, Septic - therapy
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Summary:Ten patients, suffering from severe viral or bacterial pneumonia had circulatory shock, characterised haemodynamically by normal or high cardiac output (CI = 4.1 +/- 1.2 1/min/m2) and low systemic resistance (SVR = 14 +/- 3.7 mm Hg/1/min/m2). Existence of such a hyperkinetic state greatly complicates the management of patients. Plasma volume expansion, performed in five cases of initial hypovolaemia, and Dopamine infusion (five patients) increased markedly the intra-pulmonary shunting. High level PEEP ventilation was not tolerated, despite the improvement of blood gases it produced. Extra-corporeal membrane lung oxygenation (three cases), whilst giving an initial decrease of shunting and restoring SVR, produced no long term surviors. All ten patients died from intractable shock and severe hypoxaemia. Spontaneous ventilation with positive expiratory pressure (CPAP) is believed to be an attractive alternative, due to its absence of deleterious haemodynamic effects.
ISSN:0342-4642
DOI:10.1007/BF01686047