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Klinzing S, Reinhard C, Simon T, Schurholz T, Sakr Y, Reinhart K, Marx G. Crit Care. 2007;11(Suppl 2):S13-S14. Abstract P34.
Introduction: We tested the effects of arginine vasopressin on tissue oxygenation, microvascular reactivity and oral mucosa microcirculation in patients with septic shock.
Methods: In 20 patients with septic shock, tissue microcirculation was determined before treatment with AVP (2 IU/hour), after 2 hours of treatment and 2 hours after treatment. The thenar muscle StO2 was measured by near-infrared spectroscopy (InSpectra; Hutchinson Technology, Hutchinson, MN, USA). Oral mucosal tissue oxygen saturation, microcirculatory blood flow and blood flow velocity were measured in depths of 1 and 4 mm with a laser Doppler flowmetry and remission spectroscopy system (O2C).
Results: See Table 1. Vasopressin infusion led to a significant decrease of oral mucosal oxygen saturation and blood flow, and a significant decrease of flow velocity in a depth of 1 mm. Changes in thenar tissue perfusion were not detectable.
Conclusion: Vasopressin causes a deterioration of oral mucosal blood flow but not in thenar tissue perfusion.
Table 1:
|
|
Base level |
2 hours AVP |
2 hours after AVP |
P value step 1 |
P value step 2 |
|
SO2 1 mm (%) |
79; 40–99 |
72.5; 59–88 |
83; 45–93 |
<0.05 |
<0.05 |
|
SO2 4 mm (%) |
79; 48–97 |
68; 50–93 |
81; 24–99 |
<0.05 |
<0.01 |
|
Flow 1 mm |
56; 11–390 |
33; 10–212 |
39; 10–249 |
<0.01 |
<0.01 |
|
Flow 4 mm |
332.5; 149–517 |
280; 119–511 |
331; 150–581 |
<0.05 |
<0.05 |
|
Velocity 1 mm |
22.5; 12–45 |
17.5; 11–33 |
20; 11–33 |
<0.01 |
<0.05 |