Severe Pneumocystis carinii pneumonia produces a hyperdynamic profile similar to bacterial pneumonia with sepsis.
OBJECTIVE
To investigate the effects of Pneumocystis carinii on the cardiovascular system. To compare the hemodynamic data from patients with P. carinii pneumonia with those data from patients with bacterial pneumonia with sepsis.


METHODS
Retrospective, descriptive study of prospectively gathered hemodynamic and clinical data.


METHODS
Tertiary referral hospital, medical intensive care unit.


METHODS
Forty-one consecutive patients with severe P. carinii pneumonia and 31 patients with bacterial pneumonia who had invasive hemodynamic monitoring for management of hypotension and/or hypoxemia.


RESULTS
On initial presentation, both groups had a hyperdynamic hemodynamic profile that included tachycardia, an increased cardiac index, and a low systemic vascular resistance index. The mean heart rate of the P. carinii pneumonia patients (113 +/- 3 beats/min) was significantly lower than that of the patients with bacterial pneumonia (126 +/- 4 beats/min). The cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, and pulmonary artery pressures did not differ significantly between the two groups. The patients with bacterial pneumonia had a significantly lower mean left ventricular stroke volume index and stroke work index than the patients with P. carinii pneumonia.


CONCLUSIONS
P. carinii can produce a hyperdynamic hemodynamic profile similar to that seen in patients with bacterial pneumonia with sepsis.
Parker
M M
MM
Critical Care Medicine Department, Warren G. Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892.
Ognibene
F P
FP
Rogers
P
P
Shelhamer
J H
JH
Masur
H
H
Parrillo
J E
JE
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000503:physiopathology*; D000163:Acquired Immunodeficiency Syndrome / Q000503:physiopathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000503:physiopathology*; D002648:Child; D006439:Hemodynamics; D006801:Humans; D007022:Hypotension / Q000150:complications; D007362:Intensive Care Units; D008875:Middle Aged; D011014:Pneumonia / Q000382:microbiology* / Q000503:physiopathology*; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000503:physiopathology*