Document Detail


The prognostic value of muscle StO2 in septic patients.
MedLine Citation:
PMID:  17572876     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jacques Creteur; Tiziana Carollo; Giulia Soldati; Gustavo Buchele; Daniel De Backer; Jean-Louis Vincent
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Publication Detail:
Type:  Journal Article     Date:  2007-06-16
Journal Detail:
Title:  Intensive care medicine     Volume:  33     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-23     Completed Date:  2008-02-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1549-56     Citation Subset:  IM    
Affiliation:
Erasme University Hospital, Free University of Brussels, Department of Intensive Care, Route de Lennik 808, 1070 Brussels, Belgium.
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MeSH Terms
Descriptor/Qualifier:
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:
7782-44-7/Oxygen

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


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