TY - JOUR
T1 - Mortality and regional oxygen saturation index in septic shock patients
T2 - A pilot study
AU - Rodriguez, Alejandro
AU - Lisboa, Thiago
AU - Martín-Loeches, Ignacio
AU - Díaz, Emili
AU - Trefler, Sandra
AU - Restrepo, Marcos I.
AU - Rello, Jordi
PY - 2011/5
Y1 - 2011/5
N2 - 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.
AB - 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.
KW - Hypoxia
KW - Microcirculation
KW - Near-infrared spectroscopy
KW - Sepsis
KW - Tissue oxygenation
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U2 - 10.1097/TA.0b013e318216f72c
DO - 10.1097/TA.0b013e318216f72c
M3 - Article
C2 - 21610429
AN - SCOPUS:79955755838
VL - 70
SP - 1145
EP - 1152
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 5
ER -