Low systemic vascular resistance: Differential diagnosis and outcome

Jairo Melo, Jay I. Peters

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Objective: To determine the frequency and prognosis of the various causes of low systemic vascular resistance (SVR). Design: Analysis of consecutive patients over a 5-year period; retrospective review. Setting: Medical intensive care unit of a large university hospital. Patients: Fifty- five patients with unexplained hypotension and a SVR less than 800 dynes x s/cm5. Background: There are minimal data in the medical literature determining the frequency or outcome of patients with a low SVR that is unrelated to sepsis or the sepsis syndrome. We retrospectively reviewed and analyzed all hemodynamic data in a large university hospital over a 5-year period to determine the frequency and prognosis of the various causes of low SVR. Fifty-five patients with unexplained hypotension and a SVR less than 800 dynes x s/cm5 were identified. Main results: Twenty-two patients (Groups 1 and 2) met the criteria for sepsis syndrome. The mean SVR for this group was 445 ± 168 dynes x s/cm5 with an associated mortality of 50%. Group 3 contained 20 patients with possible sepsis. Thirteen patients (Group 4) were nonseptic. The mean SVR of this group was 435 ± 180 dynes x s/cm5 with an associated mortality of 46%. Extremely low SVR (below 450 dynes x s/cm5) was associated with a significantly higher mortality regardless of the etiology. Conclusions: At least a quarter of patients with hypotension and a low SVR have nonseptic etiologies. The patients with nonseptic etiologies have a similar mortality to septic patients. Clinicians should be aware of the wide spectrum of conditions that induce a low SVR.

Original languageEnglish (US)
Pages (from-to)71-77
Number of pages7
JournalCritical Care
Volume3
Issue number3
DOIs
StatePublished - Jan 1 1999

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Keywords

  • Adrenal insufficiency
  • Anaphylaxis
  • Cirrhosis
  • Hypotension
  • Pancreatitis
  • Sepsis
  • Systemic vascular resistance

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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