The prognostic value of muscle StO2 in septic patients

Abstract

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.

Microcirculatory abnormalities in patients with severe influenza A (H1N1) infection

“…14,15,25,26 In our small series of patients, the microcirculation was moderately to severely compromised, in line with previous studies of patients with severe sepsis and septic shock. 14,22,23 For example, Creteur et al 22 reported NIRS ascending slope values of 2.3 ± 1.3%Ásec -1 in patients with septic shock, a value similar to our findings. Skarda et al 23 found NirVO 2 values of 97 ± 36 U, again in the range seen in our patients.…”

“…These findings are in line with other studies in sepsis that relate the severity of microcirculatory abnormalities to the severity of disease. 14,22,29 In conclusion, these data suggest that microcirculatory abnormalities are present in patients with acute lung injury associated with severe influenza A (H1N1) infection independently of any bacterial co-infection.…”

“…21 The NIRS technique has been detailed elsewhere. 22 Briefly, a probe was placed over the skin of the thenar eminence to register the baseline tissue oxygen saturation (StO 2 ) and the total hemoglobin index (THI), i.e., an estimate of the local tissue hemoglobin concentration. A threeminute vascular occlusive test was then performed with an arterial cuff around the arm inflated up to 50 mmHg above the systolic arterial pressure.…”

Near-Infrared Spectroscopy with Vascular Occlusion Test May Not Be the Adequate Tool to Explore Microcirculation in Pulmonary Arterial Hypertension

“…One can also imagine a different behavior of cells in chronic hypoxia, further amending the dynamic curves (ie, O 2 consumption rate, reactive hyperhemia time, and time interval) compared with the princeps work during sepsis. 4 Accordingly, elevated venous pressure has been related to impaired microvascular tissue perfusion. 5 Thus, a possible modification of post-capillary venous vessel capacitance would obscure NIRS-VOTderived values.…”

Red Blood Cell Transfusion in Sepsis: A Review

“…The specific effect of transfusion was not evaluated in this study, however, as the investigation was designed to assess the overall bundle rather than its component parts. Using Near Infrared Spectroscopy (NIRS) or Sidestream Dark Field (SDF), several investigators have reported that microcirculation is markedly altered in sepsis, that these alterations are more severe in nonsurvivors than in survivors, that persistent microvascular alterations are associated with development of multiple organ failure and death, and that microvascular alterations are the most sensitive and specific predictor of outcome in septic patients [91][92][93][94][95][96][97].…”