Web of Science: 7 cites, Scopus: 7 cites, Google Scholar: cites,
Near-infrared spectroscopy StO monitoring to assess the therapeutic effect of drotrecogin alfa (activated) on microcirculation in patients with severe sepsis or septic shock
Masip, Jordi (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Mesquida, Jaume (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Luengo, Cecilia (Department of Anesthesiology & Critical Care Medicine, SAMU and Laboratory of Anesthesiology, Hospital Lariboisière, Paris, 2, rue Ambroise - Paré, 75010 Paris, 10ème, France)
Gili, Gisela (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Gomà, Gemma (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Ferrer, Ricard (Universitat de Barcelona. Hospital Mútua de Terrassa)
Teboul, Jean Louis (Service de Réanimation Médicale, Centre Hospitalo-Universitaire de Bicêtre, 78 rue du Général-Leclerc, Le Kremlin-Bicêtre 94 270, France)
Payen, Didier (Department of Anesthesiology & Critical Care Medicine, SAMU and Laboratory of Anesthesiology, Hospital Lariboisière, Paris, 2, rue Ambroise - Paré, 75010 Paris, 10ème, France)
Artigas, Antonio (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Universitat Autònoma de Barcelona

Data: 2013
Resum: Sepsis is a leading cause of death despite appropriate management. There is increasing evidence that microcirculatory alterations might persist independently from macrohemodynamic improvement and are related to clinical evolution. Future efforts need to be directed towards microperfusion monitoring and treatment. This study explored the utility of thenar muscle oxygen saturation (StO) and its changes during a transient vascular occlusion test (VOT) to measure the microcirculatory response to drotrecogin alfa (activated) (DrotAA) in septic patients. A prospective, observational study was performed in three general intensive care units at three university hospitals. We studied 58 patients with recent onset of severe sepsis or septic shock and at least two organ dysfunctions. Thirty-two patients were treated with DrotAA and 26 were not treated because of formal contraindication. StO was monitored using near-infrared spectroscopy (NIRS), and VOT was performed to obtain deoxygenation (DeOx) and reoxygenation (ReOx) slopes. Measurements were obtained before DrotAA was started and were repeated daily for a 96-hour period. Patients' characteristics, outcome, severity, and baseline values of StO, DeOx, and ReOx did not differ between groups. Treated patients significantly improved DeOx and ReOx values over time, whereas control patients did not. In treated patients, ReOx improvements were correlated to norepinephrine dose reductions. Early clinical response (SOFA improvement after 48 hours of treatment) was not associated to changes in VOT-derived slopes. In the treated group, the relative improvement of DeOx within 48 hours was able to predict mortality (AUC 0. 91, p < 0. 01). In patients with severe sepsis or septic shock, DrotAA infusion was associated with improvement in regional tissue oxygenation. The degree of DeOx amelioration after 2 days in treated patients predicted mortality with high sensitivity and specificity. Thus, StO derived variables might be useful to evaluate the microcirculatory response to treatment of septic shock.
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: Article ; recerca ; Versió publicada
Matèria: Severe sepsis ; Septic shock ; Tissue oxygen saturation ; Near-infrared spectroscopy ; Drotrecogin alfa activated ; Outcome
Publicat a: Annals of Intensive Care, Vol. 3 (september 2013) , p. 30, ISSN 2110-5820

DOI: 10.1186/2110-5820-3-30
PMID: 24007807


9 p, 598.1 KB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
Articles > Articles de recerca
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 Registre creat el 2018-01-27, darrera modificació el 2021-08-08



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