Key result
Gram-negative bacteremia caused decreased systemic vascular resistance and central venous pressure and increased cardiac output, which was not observed with gram-positive bacteremia or no bacteremia.
Why the study?
Does gram-negative bacteremia cause different immediate hemodynamic effects compared to gram-positive bacteremia in patients undergoing genitourinary instrumentation?
Observational (n=29)
Does gram-negative bacteremia cause different immediate hemodynamic effects compared to gram-positive bacteremia in patients undergoing genitourinary instrumentation?
Gram-negative bacteremia produces a distinct immediate hemodynamic profile characterized by decreased systemic vascular resistance and central venous pressure with increased cardiac output, unlike gram-positive bacteremia.
May indicate need for closer hemodynamic monitoring with gram-negative bacteremia during instrumentation; leaves open effects on outcomes and management.
Hemodynamic measurements were made in 29 patients undergoing 31 episodes of genitourinary instrumentation. The conditions of two patients were studied twice during separate surgical episodes. Bacteremia developed with 21 procedures, gram-negative organisms in eight procedures, gram-positive organisms in ten, and both gram-negative and gram-positive organisms in three procedures. Three patients manifested clinical shock. Immediate hemodynamic effects of gram-negative bacteremia are a decrease in systemic vascular resistance and central venous pressure and an increase in cardiac output. Clinical shock is an exaggeration of these changes, but the fall in central venous pressure prevents the cardiac output from compensating for the fall in systemic vascular resistance. Patients with gram-positive bacteremia and abacteremic patients undergoing similar instrumentations do not demonstrate comparable hemodynamic changes.
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Charlotte Blain (1970) conducted an observational in Genitourinary instrumentation (n=29). Gram-negative bacteremia vs. Gram-positive bacteremia and abacteremic patients was evaluated on Immediate hemodynamic effects (systemic vascular resistance, central venous pressure, cardiac output). Gram-negative bacteremia caused decreased systemic vascular resistance and central venous pressure and increased cardiac output, which was not observed with gram-positive bacteremia or no bacteremia.
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