| The prognostic value of muscle StO2 in septic patients. | |
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MedLine Citation:
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PMID: 17572876 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To quantify sepsis-induced alterations in changes in muscle tissue oxygenation (StO(2)) after an ischemic challenge using near-infrared spectroscopy (NIRS), and to test the hypothesis that these alterations are related to outcome. DESIGN: Prospective study. SETTING: Thirty-one-bed, university hospital Department of Intensive Care. PATIENTS: Seventy-two patients with severe sepsis or septic shock, 18 hemodynamically stable, acutely ill patients without infection, and 18 healthy volunteers. INTERVENTIONS: Three-minute occlusion of the brachial artery using a cuff inflated 50[Symbol: see text]mmHg above systolic arterial pressure. MEASUREMENTS AND MAIN RESULTS: Thenar eminence StO(2) was measured continuously by NIRS before (StO(2)baseline), during, and after the 3-min occlusion. Changes in StO(2) were assessed by the slope of increase in StO(2) during the first 14 s following the ischemic period and by the difference between the maximum StO(2) and StO(2)baseline (Delta). The slope was lower in septic patients than in controls and volunteers [2.3 (1.3-3.6), 4.8 (3.5-6.0), and 4.7 (3.2-6.3) %/s, p < 0.001]. Delta was also significantly lower in septic patients than in the other groups. Slopes were lower in septic patients with than without shock [2.0 (1.2-2.9) vs 3.2 (1.8-4.5) %/s, p < 0.05]. In 52 septic patients, in whom the slope was obtained every 24 h for 48 h, slopes were higher in survivors than in non-survivors and tended to increase in survivors but not in non-survivors. CONCLUSIONS: Altered recovery in StO(2) after an ischemic challenge is frequent in septic patients and more pronounced in the presence of shock. The presence and persistence of these alterations in the first 24[Symbol: see text]h of sepsis are associated with worse outcome. |
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Authors:
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Jacques Creteur; Tiziana Carollo; Giulia Soldati; Gustavo Buchele; Daniel De Backer; Jean-Louis Vincent |
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Publication Detail:
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Type: Journal Article Date: 2007-06-16 |
Journal Detail:
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Title: Intensive care medicine Volume: 33 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-23 Completed Date: 2008-02-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1549-56 Citation Subset: IM |
Affiliation:
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Erasme University Hospital, Free University of Brussels, Department of Intensive Care, Route de Lennik 808, 1070 Brussels, Belgium. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Case-Control Studies Female Humans Intensive Care Units Male Microcirculation Middle Aged Muscle, Skeletal / blood supply, metabolism* Oxygen / metabolism* Prognosis Prospective Studies ROC Curve Sensitivity and Specificity Sepsis / metabolism*, mortality* Spectroscopy, Near-Infrared |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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