Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Carollo T, Creteur J, De Backer D, Vincent JL. Int Care Med. 2004;30(Supp 1):S163. Abstract 626.
Introduction: We hypothesised that the persistence of the altered microvascular response to reactive hyperaemia is associated with a worse outcome in septic patients.Methods: Thenar eminence tissue O2 saturation (StO2) was continuously measured by NIRS in 37 patients with severe sepsis or septic shock before, during and after a 3 min arterial occlusion. Vasoreactivity was assessed daily during the first 3 days of diagnosis of sepsis, by the calculation of the slope of the increase in StO2 during the first 14 seconds following the ischemic period (slope [%/sec]). Daily slopes in survivors (S) and non-survivors (NS) were compared by ANOVA.
Results: The overall mortality was 43% (16/37). There was no difference in slopes between S and NS groups on day 1. On day 2 and day 3, slopes were significantly higher in the S than in the NS group.
|
|
S |
NS |
p |
|
Day 1 |
3.5±1.5 |
3.1±1.7 |
0.13 |
|
Day 2 |
3.6±1.3 |
2.6±1.5 |
<0.05 |
|
Day 3 |
4.2±1.3 |
2.6±1.7 |
<0.05 |
Conclusion: NIRS can be used to monitor vascular reactivity in septic patients. An improvement during the first few days of admission is associated with a better outcome.