| Non-invasive assessment of the microcirculation in critically ill patients. | |
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MedLine Citation:
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PMID: 19775036 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Sepsis is associated with abnormalities of muscle tissue oxygenation and of microvascular function. We investigated whether the technique of near-infrared spectroscopy can evaluate such abnormalities in critically ill patients and compared near-infrared spectroscopy-derived indices of critically ill patients with those of healthy volunteers. We studied 41 patients (mean age 58 +/- 22 years) and 15 healthy volunteers (mean age 49 +/- 13 years). Patients were classified into one of three groups: systemic inflammatory response syndrome (SIRS) (n = 21), severe sepsis (n = 8) and septic shock (n = 12). Near-infrared spectroscopy was used to continuously measure thenar muscle oxygen saturation before, during and after a three-minute occlusion of the brachial artery via pneumatic cuff. Oxygen saturation was significantly lower in patients with SIRS, severe sepsis or septic shock than in healthy volunteers. Oxygen consumption rate during stagnant ischaemia was significantly lower in patients with SIRS (23.9 +/- 7.7%/minute, P < 0.001), severe sepsis (16.9 +/- 3.4%/minute, P < 0.001) or septic shock (14.8 +/- 6%/minute, P < 0.001) than in healthy volunteers (35.5 +/- 10.6%/minute). Furthermore, oxygen consumption rate was significantly lower in patients with septic shock than patients with SIRS. Reperfusion rate was significantly lower in patients with SIRS (336 +/- 141%/minute, P < 0.001), severe sepsis (257 +/- 150%/minute, P < 0.001) or septic shock (146 +/- 101%/minute, P < 0.001) than in healthy volunteers (713 +/- 223%/minute) and significantly lower in the septic shock than in the SIRS group. Near-infrared spectroscopy can detect tissue oxygenation deficits and impaired microvascular reactivity in critically ill patients, as well as discriminate among groups with different disease severity. |
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Authors:
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S Nanas; V Gerovasili; P Renieris; E Angelopoulos; M Poriazi; K Kritikos; A Siafaka; I Baraboutis; D Zervakis; V Markaki; C Routsi; C Roussos |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Anaesthesia and intensive care Volume: 37 ISSN: 0310-057X ISO Abbreviation: Anaesth Intensive Care Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-24 Completed Date: 2010-01-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0342017 Medline TA: Anaesth Intensive Care Country: Australia |
Other Details:
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Languages: eng Pagination: 733-9 Citation Subset: IM |
Affiliation:
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First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Brachial Artery / metabolism Critical Illness* Female Humans Ischemia / blood Male Microcirculation* Middle Aged Muscle, Skeletal / blood supply, metabolism Oxygen / blood* Oxygen Consumption Resuscitation / methods Sepsis / blood* Shock, Septic / blood Spectroscopy, Near-Infrared Systemic Inflammatory Response Syndrome / blood* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
| Comments/Corrections | |
Comment In:
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Anaesth Intensive Care. 2009 Sep;37(5):700-2
[PMID:
19775031
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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