Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods

Microvascular dysfunction has been associated with adverse outcomes in critically ill patients, and the current concept of hemodynamic incoherence has gained attention. Our objective was to perform a comprehensive analysis of microcirculatory perfusion parameters and to investigate the best variable...

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Autores principales: Rabello Filho, Roberto, Carneiro de Freitas Chaves, Renato, Assunção, Murillo Santucci Cesar de, Serpa Neto, Ary, Manfredi De Freitas, Flavia, Romagnoli, María Laura, Silva, Eliézer, Lattanzio, Bernardo, Dubin, Arnaldo, Corrêa, Thiago Domingos
Formato: Articulo
Lenguaje:Inglés
Publicado: 2020
Materias:
Ciencias Médicas
Critical care
Shock
Hemodynamics
Microcirculation
Oxygen consumption
Near-infrared spectroscopy
Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/146268
Aporte de:
SEDICI (UNLP) de Universidad Nacional de La Plata
id I19-R120-10915-146268
record_format dspace
institution Universidad Nacional de La Plata
institution_str I-19
repository_str R-120
collection SEDICI (UNLP)
language Inglés
topic Ciencias Médicas
Critical care
Shock
Hemodynamics
Microcirculation
Oxygen consumption
Near-infrared spectroscopy
spellingShingle Ciencias Médicas
Critical care
Shock
Hemodynamics
Microcirculation
Oxygen consumption
Near-infrared spectroscopy
Rabello Filho, Roberto
Carneiro de Freitas Chaves, Renato
Assunção, Murillo Santucci Cesar de
Serpa Neto, Ary
Manfredi De Freitas, Flavia
Romagnoli, María Laura
Silva, Eliézer
Lattanzio, Bernardo
Dubin, Arnaldo
Corrêa, Thiago Domingos
Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods
topic_facet Ciencias Médicas
Critical care
Shock
Hemodynamics
Microcirculation
Oxygen consumption
Near-infrared spectroscopy
description Microvascular dysfunction has been associated with adverse outcomes in critically ill patients, and the current concept of hemodynamic incoherence has gained attention. Our objective was to perform a comprehensive analysis of microcirculatory perfusion parameters and to investigate the best variables that could discriminate patients with and without circulatory shock during early intensive care unit (ICU) admission. This prospective observational study comprised a sample of 40 adult patients with and without circulatory shock (n = 20, each) admitted to the ICU within 24 h. Peripheral clinical [capillary refill time (CRT), peripheral perfusion index (PPI), skin-temperature gradient (Tskin-diff)] and laboratory [arterial lactate and base excess (BE)] perfusion parameters, in addition to near-infrared spectroscopy (NIRS)-derived variables were simultaneously assessed. While lactate, BE, CRT, PPI and Tskin-diff did not differ significantly between the groups, shock patients had lower baseline tissue oxygen saturation (StO₂) [81 (76–83) % vs. 86 (76–90) %, p = 0.044], lower StO₂min [50 (47–57) % vs. 55 (53–65)  %, p = 0.038] and lower StO₂max [87 (80–92) % vs. 93 (90–95) %, p = 0.017] than patients without shock. Additionally, dynamic NIRS variables [recovery time (r = 0.56, p = 0.010), descending slope (r = − 0.44, p = 0.05) and ascending slope (r = − 0.54, p = 0.014)] and not static variable [baseline StO₂ (r = − 0.24, p = 0.28)] exhibited a significant correlation with the administered dose of norepinephrine. In our study with critically ill patients assessed within the first twenty-four hours of ICU admission, among the perfusion parameters, only NIRS-derived parameters could discriminate patients with and without shock.
format Articulo
Articulo
author Rabello Filho, Roberto
Carneiro de Freitas Chaves, Renato
Assunção, Murillo Santucci Cesar de
Serpa Neto, Ary
Manfredi De Freitas, Flavia
Romagnoli, María Laura
Silva, Eliézer
Lattanzio, Bernardo
Dubin, Arnaldo
Corrêa, Thiago Domingos
author_facet Rabello Filho, Roberto
Carneiro de Freitas Chaves, Renato
Assunção, Murillo Santucci Cesar de
Serpa Neto, Ary
Manfredi De Freitas, Flavia
Romagnoli, María Laura
Silva, Eliézer
Lattanzio, Bernardo
Dubin, Arnaldo
Corrêa, Thiago Domingos
author_sort Rabello Filho, Roberto
title Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods
title_short Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods
title_full Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods
title_fullStr Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods
title_full_unstemmed Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods
title_sort assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods
publishDate 2020
url http://sedici.unlp.edu.ar/handle/10915/146268
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