Author/Editor		Parežnik, Roman
Title		Spremembe tkivne oksigenacije mišic med zastojno ishemijo pri septičnih bolnikih
Type		monografija
Place		Ljubljana
Publisher		Univerza v Ljubljani, Medicinska fakulteta
Publication year		2006
Volume		str. 50
Language		slo
Abstract		Objective: To determine changes in the rate of thenar muscles tissue deoxygenation during stagnant iscbemia in patients with severe sepsis and septic shock. Uesign: Prospective observational study Setting: Medical ICU in general hospital Patients and participants: Consecutive patients admitted to ICU with septic shock (6), severe sepsis (6), localized infection (3), and healthy volunteers (15) Interventions: Upper limb ischemia was induced by rapid automatic pneumatic cuff inflation around upper arm. Measurements and main results: Thenar muscle tissue oxygen saturation (StO2) was measured continuously by near-infrared spectroscopy before and during upper limb ischemia. StO2 before intervention was comparable in patients with septic shock, severe sepsis, localized infection and healthy volunteers (89 [65, 92]% vs. 82 [72, 91]% vs. 87 [85, 92]% vs. 83 [79, 93]%, respectively; p>0.1). StO2 decrease rate during stagnant ischemia after initial haemodynamic stabilization was slower in septic shock patients compared to severe sepsis, localized infection and controls (-7.0 [-3.6, -11.0] %/min vs. -10.4 [-7.8, -133] %/min vs. 19.5 [-12.3, -233] vs. -37.4 [-273, -56.2] %/min, respectively; p=0.041). At ICU discharge StO2 decrease rate did not differ between septic shock, severe sepsis and localized infection group (-17.0 [-93, -28.9] %/min vs. -19.9 [-133, -23.6]%/min vs. 23.1 [-20.7, -26.2]%/min, respectively), but remained slower compared to controls (p<0.01). StO2 decrease rate correlated with SOFA score (r =0.739, p<0.001). Conclusions: After haemodynamic stabilization thenar muscle tissue oxygen saturation during stagnant ischemia decreases slower in septic shock patients compared to patients with severe sepsis, localized infection and healthy volunteers. (Abstract truncated at 2000 characetrs)
Descriptors		SEPSIS SHOCK, SEPTIC OXIMETRY ISCHEMIA INFECTION INTENSIVE CARE UNITS SPECTROSCOPY, NEAR-INFRARED