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Prognostic implications of tissue oxygen saturation in human septic shock

Mesquida, J and Espinal, C and Gruartmoner, G and Masip, J and Sabatier, C and Baigorri, F and Pinsky, MR and Artigas, A (2012) Prognostic implications of tissue oxygen saturation in human septic shock. Intensive Care Medicine, 38 (4). 592 - 597. ISSN 0342-4642

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Abstract

Purpose: To analyze the prognostic value of tissue oxygen saturation (StO2) in septic shock patients with restored mean arterial pressure (MAP). Methods: This was a prospective observational study of patients admitted to the ICU in the early phase of septic shock, after restoration of MAP. Demographic data, severity score, hemodynamics, blood lactate, acid-base status, and StO2 were measured at inclusion followed by a transient vascular occlusion test (VOT) to obtain the StO2-deoxygenation (DeOx) and StO2-reoxygenation (ReOx) rates. Sequential organ failure assessment (SOFA) score was measured at inclusion and after 24 h. Results: Thirty-three patients were studied. StO2 was 76 ± 10%, DeOx -12.2 ± 4.2%/min, and ReOx 3.02 ± 1.70%/s. MAP showed a significant correlation with VOT-derived slopes (r = -0.4, p = 0.04 for DeOx; and r = 0.55, p\0.01 for ReOx). After 24 h, 17 patients (52%) had improved SOFA scores. Patients who did not improve their SOFA showed less negative DeOx values at inclusion. The association between DeOx and SOFA evolution was not affected by MAP. Both DeOx and ReOx impairment correlated with longer ICU stay (r = 0.44, p = 0.05; and r = -0.43, p = 0.05, respectively). Conclusions: In a population of septic shock patients with restored MAP, impaired DeOx was associated with no improvement in organ failures after 24 h. Decrements in DeOx and ReOx were associated with longer ICU stay. DeOx and ReOx were linked to MAP, and thus, their interpretation needs to be made relative to MAP. © Copyright jointly held by Springer and ESICM 2012.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Mesquida, J
Espinal, C
Gruartmoner, G
Masip, J
Sabatier, C
Baigorri, F
Pinsky, MRpinsky@pitt.eduPINSKY
Artigas, A
Centers: Other Centers, Institutes, or Units > McGowan Institute for Regenerative Medicine
Date: 1 April 2012
Date Type: Publication
Journal or Publication Title: Intensive Care Medicine
Volume: 38
Number: 4
Page Range: 592 - 597
DOI or Unique Handle: 10.1007/s00134-012-2491-6
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0342-4642
PubMed ID: 22310873
Date Deposited: 18 Oct 2012 21:13
Last Modified: 30 Oct 2017 23:57
URI: http://d-scholarship.pitt.edu/id/eprint/16005

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