Cardiovascular changes in infants with beta-hemolytic streptococcus sepsis.
Sequential hemodynamic and biochemical changes were studied in 24 infants with sepsis due to beta-hemolytic streptococcus to define the temporal patterns of physiologic events and to compare them in surviving (n = 11) and nonsurviving (n = 13) infants. Septicemia was documented by positive blood culture in all. Biophysical and biochemical measurements were obtained before and hourly, for 11 h after antibiotic therapy was initiated. Surviving infants had significantly higher Hct and systolic and mean arterial pressures than nonsurvivors. In nonsurvivors, low BP was associated with a concomitant rise in CVP and severe metabolic acidosis refractory to therapy. Although there were no differences in PaO2 or PaCO2 between survivors and nonsurvivors, arterial-alveolar oxygen gradients were significantly greater in nonsurviving infants. These data show cardiorespiratory and metabolic alterations that differentiate surviving and nonsurviving infants with beta-hemolytic streptococcal septicemia.
Cabal
L A
LA
Department of Pediatrics, University of Southern California School of Medicine, Women's Hospital, Los Angeles 90033.
Siassi
B
B
Cristofani
C
C
Cabal
C
C
Hodgman
J E
JE
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001724:Birth Weight; D003422:Critical Care; D005260:Female; D005865:Gestational Age; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D011659:Pulmonary Gas Exchange; D013290:Streptococcal Infections / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology*; D013292:Streptococcus agalactiae
D000900:Anti-Bacterial Agents