Mortality and regional oxygen saturation index in septic shock patients: A pilot study

Alejandro Rodriguez, Thiago Lisboa, Ignacio Martín-Loeches, Emili Díaz, Sandra Trefler, Marcos I. Restrepo, Jordi Rello

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: Peripheral muscle tissue oxygenation determined noninvasively using near-infrared spectroscopy may help to identify tissue hypoperfusion in septic patients. The aim of this study was to investigate regional oxygen saturation index (rSO2) in the brachioradialis (forearm) muscle by comparing measurements in healthy subjects and in intensive care unit (ICU) septic shock patients, and determine whether brachioradialis muscle rSO2 is associated with poor outcome in ICU septic shock patients. Methods: We conducted a prospective observational study in healthy volunteers (n = 50) and ICU septic shock patients (n = 19). Brachioradialis (forearm) rSO2 measurements in healthy volunteers at rest and in ICU septic shock patients were compared. Pulmonary artery catheter monitoring was used in ICU patients. Results: Significant differences in rSO2 were observed between healthy volunteers and ICU septic shock patients at ICU admission (68.7 ± 4.9 vs. 55.0 ± 13.0; p < 0.001). When comparing septic shock survivors and nonsurvivors, significant differences were observed in rSO2 at baseline (64.5 ± 8.9 vs. 47.5 ± 10.7; p < 0.01), 12 hours (67.3 ± 9.6 vs. 45.0 ± 14.9; p < 0.01), and 24 hours (65.7 ± 7.0 vs. 50.1 ± 10.3; p < 0.01). Lactate concentration was lower in survivors than nonsurvivors at 24 hours (12.0 ± 7.5 mmol/L vs. 23.2 ± 12.5 mmol/L; p < 0.04). Cardiac index was greater in nonsurvivors than survivors at baseline (4.6 + 1.9 L/min/m vs. 3.0 + 0.9 L/min/m; p < 0.05) and 12 h (3.9 + 0.5 L/min/m vs. 3.1 + 0.3 L/min/m; p < 0.05). We observed that septic shock patients with forearm skeletal muscle rSO2 ≤60% throughout first 24 hours after ICU admission had significantly greater mortality rate than patients with forearm skeletal muscle rSO2 >60% throughout this critical time.

Original languageEnglish (US)
Pages (from-to)1145-1152
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume70
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • Hypoxia
  • Microcirculation
  • Near-infrared spectroscopy
  • Sepsis
  • Tissue oxygenation

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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