Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Pujol W, Vargas F, Bui HN, Clouzeau B, Herpe B, Medrano J, Garnier S, Boyer A, Pillet O, Gruson D, Hilbert G, Gbikpi-Benissan G, Castaing Y. Crit Care Med. 2007;35(12, Abstract Supplement):A77. Abstract 293.
Introduction: Septic shock is associated with alterations in tissue oxygenation.
Hypothesis: We study tissue oxygenation and reactive hyperemia by nearinfrared spectroscopy (NIRS) before, during and after stagnant ischemia in patients with septic shock. We hypothesized that changes in muscle tissue oxygen saturation are related to outcome.
Methods: We conducted a prospective observational study in a medical ICU of a university hospital. Ten patients with septic shock, twenty-one healthy volunteers, and twenty non septic medical critical ill patients were included. Thenar muscle tissue oxygen saturation (St02) was measured continuously by NIRS before and during upper limb ischemia one time in healthy volunteers and non septic patients and during three days in patients with septic shock.
Results: The rate of StO2 increase (RR) after stagnant ischemia was slower in septic shock patients than in healthy volunteers (1,58±1,09 %/sec vs 3,70±1,47 %/sec ; p=0,001), and was slower in non septic critical ill patients than in healthy volunteers (2,05±0,96 %/sec vs 3,70±1,47 %/sec; p=0,001). RR was improved in day-2 and day-3 in survivors (5 patients on 10) of septic shock (2,85±0,84 vs 1,58±1,09 (p=0,03) and 3,12±0,51 vs 1,58±1,09 (p=0,03) respectively). We have found no significant difference between septic shock patients and critical ill patients.
Conclusions: Muscle tissue oxygen saturation after stagnant ischemia increases slower in septic shock patients and non septic critical ill patients than in healthy volunteers. During ICU stay and improvement of sepsis reactive hyperemia increases in survivors of septic shock.