Document Detail


Non-invasive assessment of the microcirculation in critically ill patients.
MedLine Citation:
PMID:  19775036     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  37     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-24     Completed Date:  2010-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  733-9     Citation Subset:  IM    
Affiliation:
First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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MeSH Terms
Descriptor/Qualifier:
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:
7782-44-7/Oxygen
Comments/Corrections
Comment In:
Anaesth Intensive Care. 2009 Sep;37(5):700-2   [PMID:  19775031 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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