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Intensive Care Medicine
Published in: Intensive Care Medicine 12/2005

01-12-2005 | Original

Microvascular dysfunction and skeletal muscle oxygenation assessed by phase-modulation near-infrared spectroscopy in patients with septic shock

Authors: Roberto Alberto De Blasi, Stefano Palmisani, Daniela Alampi, Marco Mercieri, Rocco Romano, Saul Collini, Giovanni Pinto

Published in: Intensive Care Medicine | Issue 12/2005

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Abstract

Objective

Sepsis is now considered a disease of the microcirculation. Little is known about the various sepsis-induced changes responsible for microvascular dysfunction. We investigated human microvascular function, regulation, oxygenation, and cellular metabolism during subacute septic shock.

Design and setting

Prospective case-control study in a nine-bed polyvalent surgical ICU of a university hospital.

Patients and participants

A prospectively enrolled group of 26 patients (13 with septic shock, 13 nonseptic postsurgical patients) and 15 healthy volunteer controls.

Measurements and results

The absolute tissue hemoglobin concentrations (oxygenated hemoglobin and deoxyhemoglobin) were measured noninvasively in arterioles, capillaries, and venules by phase-modulation near-infrared spectroscopy in the human brachioradial muscle during a series of venous occlusions and an arterial occlusion (ischemia) induced by applying a pneumatic cuff. These measurements were used to calculate tissue blood volume, postischemic hemoglobin resaturation time, microvascular compliance, and O2 consumption. Patients with sepsis had significantly higher tissue blood volume values and lower compliance than healthy controls. They also had longer postischemic hemoglobin resaturation times than the other two groups and blunted resaturation curves. O2 consumption was lower in patients with sepsis than in healthy controls. In patients with septic shock cuff-induced ischemia left O2 consumption unchanged, whereas in healthy volunteers it reduced O2 consumption to values almost matching those of patients with septic shock.

Conclusions

These findings show that septic shock alters microvascular muscle function and regulation. Diminished local VO2 presumably reflects maldistribution and faulty autoregulation of local blood flow.
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Metadata
Title
Microvascular dysfunction and skeletal muscle oxygenation assessed by phase-modulation near-infrared spectroscopy in patients with septic shock
Authors
Roberto Alberto De Blasi
Stefano Palmisani
Daniela Alampi
Marco Mercieri
Rocco Romano
Saul Collini
Giovanni Pinto
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 12/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2822-y

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