Please see Bibliography of References for a list of abstracts, manuscripts and posters.

Microvascular Dysfunction

Microvascular response to reactive hyperemia is altered in septic patients

Carollo T, Creteur J, De Backer D, Vincent JL. Int Care Med. 2004;30(Supp 1):S24. Abstract 074.

Introduction: Microvascular alterations are frequent in sepsis, and may include impaired vascular reactivity. We tested the hypothesis that septic patients have an impaired microvascular response during reactive hyperaemia using near-infrared spectroscopy (NIRS), a non-invasive technique using the differential absorption properties of haemoglobin to evaluate skeletal muscle oxygenation.

Methods: Thenar eminence tissue O₂ saturation (StO₂) was continuously measured by NIRS in 51 patients with severe sepsis or septic shock (SP group), in 10 acutely ill patients without infection (ICU control) and in 18 healthy volunteers (HV) before (baseline StO₂), during and after a 3 minutes arterial occlusion. Vasoreactivity was assessed by the calculation of the slope of the increase in StO₂ during the first 14 seconds following the ischemic period (slope [%/sec]).

Results: There was no difference in StO₂ baseline and slope between ICU control and HV groups. The slope was less steep in the SP group than in ICU and HV groups (both p<0.01). In septic patients, there was no difference in slope between patients with severe sepsis and septic shock and between patients treated with high or low doses of catecholamines.

Conclusion: Alterations in vascular reactivity can be demonstrated by the NIRS technique in septic patients. These alterations are not significantly influenced either by the severity of sepsis or by the adrenergic support.