Document Detail

Significance of the pulmonary artery diastolic-pulmonary wedge pressure gradient in sepsis.
MedLine Citation:
PMID:  7116887     Owner:  NLM     Status:  MEDLINE    
An initially widened pulmonary artery diastolic-pulmonary wedge pressure (PAD-PWP) gradient greater than 5 mm Hg has been reported to be associated with an 83% mortality rate in septic patients. To confirm and extend these observations, we retrospectively reviewed the charts of 47 septic patients. The patients were divided into 2 groups: group 1-12 patients who never had an abnormal gradient during their hospital course, and group 2-35 patients who had an abnormal gradient sometimes during their course. There were no hemodynamic differences. However, the mortality rate in group 2 patients was significantly higher than in group 1 patients (60% vs 25%, p less than 0.01). In patients with an initial gradient, the mortality rate was 61% which is not significantly different than the 83% previously reported. In patients with a persistent or increasing gradient before death or the resolution of sepsis, the mortality rate was 91%. We conclude that although an initial PAD-PWP gradient in patients with sepsis is associated with a high mortality, a much more sensitive indicator is whether the gradient increases or persists over time. There is a 91% mortality in patients with persisting or increasing gradients.
A M Marland; F L Glauser
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care medicine     Volume:  10     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1982 Oct 
Date Detail:
Created Date:  1982-12-03     Completed Date:  1982-12-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  658-61     Citation Subset:  AIM; IM    
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MeSH Terms
Blood Pressure*
Critical Care
Infection / physiopathology*
Middle Aged
Pulmonary Artery
Pulmonary Wedge Pressure*
Retrospective Studies

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