Oxygen Tissue Saturation Is Lower in Nonsurvivors than in Survivors after Early Resuscitation of Septic Shock

Léone, Marc; Blidi, Sami; Antonini, François; Meyssignac, B.; Bordon, Sébastien; Garcin, Frédéric; Charvet, A.; Blasco, V.; Albanèse, Jacques; Martin, Claude

doi:10.1097/aln.0b013e3181aae72d

Cited by 114 publications

(69 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The StO 2 can be thus normal or even increased when the venous blood compartment volume is relatively reduced and/or when arterio-venous shuntings result in increased O 2 saturation of the venous blood. In septic patients, the variable degree of arterial vasodilation and of vascular shuntings probably accounts for the great heterogeneity of StO 2 values measured in septic shock patients in our study as in others [15][16][17][20][21][22][23] and for the fact that high values of StO 2 were measured in some of them [15,16,23].…”

Section: Discussionmentioning

confidence: 79%

Restoring arterial pressure with norepinephrine improves muscle tissue oxygenation assessed by near-infrared spectroscopy in severely hypotensive septic patients

et al. 2010

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 79%

Restoring arterial pressure with norepinephrine improves muscle tissue oxygenation assessed by near-infrared spectroscopy in severely hypotensive septic patients

et al. 2010

View full text Add to dashboard Cite

show abstract

“…However, the predictive value of thenar StO 2 is still under debate. In a cohort of 43 patients, Payen et al [23] did not find any difference of thenar StO 2 between survivors and non-survivors, whereas Leone et al [8] Knee StO 2 (%) according to mottling score at H6, after initial resuscitation. The higher the mottling score was, the lower the knee StO 2 (P \ 0.01).…”

Section: Discussionmentioning

confidence: 99%

“…NIRS estimates tissue oxygenation and indirectly informs one about microcirculation status [7]. Leone et al [8] reported that thenar StO 2 was a prognostic factor in septic patients after initial resuscitation. In our ICU, we were interested in clinical evaluation of microcirculation and we focused on mottling.…”

mentioning

confidence: 99%

Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock

et al. 2012

View full text Add to dashboard Cite

show abstract

“…A study[17] revealed that oxygen tissue saturation (StO 2 ) is less or not related to SvO 2 , urine output and lactate, suggesting that global perfusion is not consistent with local tissue perfusion. In our study, PtcO 2 , PtcO 2 /FiO 2 and PtcCO 2 were not correlated to DO 2 , VO 2 , O 2 ext, ScvO 2 and lactate, showing that global tissue perfusion and oxygenation were not in accord with local perfusion and oxygenation.…”

Section: Discussionmentioning

confidence: 99%

Effect of early goal directed therapy on tissue perfusion in patients with septic shock

Lu¹,

Liu²,

Qiu³

et al. 2013

World Journal of Emergency Medicine

View full text Add to dashboard Cite

BACKGROUND:This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock.METHODS:Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 months), and they didn’t meet the criteria of EGDT. Patients who had one of the following were excluded: stroke, brain injury, other types of shock, severe heart failure, acute myocardial infarction, age below 18 years, pregnancy, end-stage disease, cardiac arrest, extensive burns, oral bleeding, difficulty in opening the mouth, and the onset of septic shock beyond 24 hours. Patients treated with the standard protocol of EGDT were included. Transcutaneous pressure of oxygen and carbon dioxide (PtcO2, PtcCO2) were monitored and hemodynamic measurements were obtained. Side-stream dark field (SDF) imaging device was applied to obtain sublingual microcirculation. Hemodynamics, tissue oxygen, and sublingual microcirculation were compared before and after EGDT. If the variable meets the normal distribution, Student's t test was applied. Otherwise, Wilcoxon's rank-sum test was used. Correlation between variables was analyzed with Pearson's product-moment correlation coefficient method.RESULTS:Twenty patients were involved, but one patient wasn’t analyzed because he didn’t meet the EGDT criteria. PtcO2 and PtcCO2 were monitored in 19 patients, of whom sublingual microcirculation was obtained. After EGDT, PtcO2 increased from 62.7±24.0 mmHg to 78.0±30.9 mmHg (P<0.05) and tissue oxygenation index (PtcO2/FiO2) was 110.7±60.4 mmHg before EGDT and 141.6±78.2 mmHg after EGDT (P<0.05). The difference between PtcCO2 and PCO2 decreased significantly after EGDT (P<0.05). The density of perfused small vessels (PPV) and microcirculatory flow index of small vessels (MFI) tended to increase, but there were no significant differences between them (P>0.05). PtcO2, PtcO2/FiO2, and PtcCO2 were not linearly related to central venous saturation, lactate, oxygen delivery, and oxygen consumption (P>0.05).CONCLUSION:Peripheral perfusion was improved after EGDT in patients with septic shock, and it was not exactly reflected by the index of systemic perfusion.

show abstract

Oxygen Tissue Saturation Is Lower in Nonsurvivors than in Survivors after Early Resuscitation of Septic Shock

Abstract: In septic shock patients, tissue oxygen saturation below 78% is associated with increased mortality at day 28. Further investigations are required to determine whether the correction of an impaired level of tissue oxygen saturation may improve the outcome of these patients.

Cited by 114 publications

References 26 publications

Restoring arterial pressure with norepinephrine improves muscle tissue oxygenation assessed by near-infrared spectroscopy in severely hypotensive septic patients

Restoring arterial pressure with norepinephrine improves muscle tissue oxygenation assessed by near-infrared spectroscopy in severely hypotensive septic patients

Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock

Effect of early goal directed therapy on tissue perfusion in patients with septic shock

Contact Info

Product

Resources

About