Journal ArticleDOI
Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome.
Daniel De Backer,Katia Donadello,Yasser Sakr,Gustavo A. Ospina-Tascón,Diamantino Salgado,Sabino Scolletta,Jean Louis Vincent +6 more
TLDR
Microcirculatory alterations are stronger predictors of outcome than global hemodynamic variables in patients with severe sepsis.Abstract:
Objectives: Sepsis induces microvascular alterations that may play an important role in the development of organ dysfunction. However, the relationship of these alterations to systemic variables and outcome is still not well defined. We investigated which factors may influence microcirculatory alterations in patients with severe sepsis and whether these are independently associated with mortality. Design: Analysis of prospectively collected data from previously published studies by our group. Setting: A 36-bed, medicosurgical university hospital Department of Intensive Care. Patients: A total of 252 patients with severe sepsis in whom the sublingual microcirculation was visualized using orthogonal polarization spectral or sidestream darkfield imaging techniques. Measurements and Main Results: Microcirculatory measurements were obtained either early, within 24 h of the onset of severe sepsis (n = 204), or later, after 48 h (n = 48). When multiple measurements were obtained, only the first was considered. Although global hemodynamic variables were relatively preserved (mean arterial pressure 70 [65–77] mm Hg, cardiac index 3.3 [2.7–4.0] L/min.m 2 , and Svo 2 68.3 [62.8–74.7]%),read more
Citations
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Journal ArticleDOI
Microcirculatory dysfunction in sepsis: pathophysiology, clinical monitoring, and potential therapies
Marcos Lopes de Miranda,Michelle M. Balarini,Daniella Mancino da Luz Caixeta,Eliete Bouskela +3 more
TL;DR: Fundamental aspects of septic microcirculatory abnormalities are discussed, including pathophysiology, clinical monitoring, and potential therapies.
Journal ArticleDOI
Association of sublingual microcirculation parameters and endothelial glycocalyx dimensions in resuscitated sepsis
Alexandros Rovas,Laura Seidel,Hans Vink,Timo Pohlkötter,Hermann Pavenstädt,Christian Ertmer,Michael Hessler,Philipp Kümpers +7 more
TL;DR: It is suggested that eGC damage can occur independently of microcirculatory impairment as measured by classical consensus parameters and further studies in critically ill patients are needed to unravel the relationship of glycocalyx damage and microvascular impairment, as well as their prognostic and therapeutic importance in sepsis.
Journal ArticleDOI
Vascular responsiveness determined by near-infrared spectroscopy measures of oxygen saturation
Kaitlin M. McLay,Federico Y. Fontana,Josh P. Nederveen,Federico F. Guida,Donald H. Paterson,Silvia Pogliaghi,Juan M. Murias,Juan M. Murias +7 more
TL;DR: In this paper, the authors used NIRS-derived slope 2 StO2 as a measure of vascular endothelial function and established a correlation between slope 2 stO2 and flow-mediated dilation (FMD) in healthy young men.
Journal ArticleDOI
Cutaneous microcirculation in preterm neonates: comparison between sidestream dark field (SDF) and incident dark field (IDF) imaging
TL;DR: IDF imaging of the cutaneous microcirculation in preterm neonates resulted in a higher vessel density and lower perfusion compared to the existing SDF device.
Journal ArticleDOI
Monitoring the microcirculation
TL;DR: The relevance of the various tools available to monitor the microcirculation is discussed, with a focus on Videomicroscopic devices such as sidestream darkfield imaging and near infrared spectroscopy.
References
More filters
Journal ArticleDOI
APACHE II: a severity of disease classification system.
TL;DR: The form and validation results of APACHE II, a severity of disease classification system that uses a point score based upon initial values of 12 routine physiologic measurements, age, and previous health status, are presented.
Journal ArticleDOI
Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012.
R. P. Dellinger,Mitchell M. Levy,Andrew Rhodes,Djillali Annane,Herwig Gerlach,Steven M. Opal,Jonathan E. Sevransky,Charles L. Sprung,Ivor S. Douglas,Roman Jaeschke,Tiffany M. Osborn,Mark E. Nunnally,Konrad Reinhart,Ruth M. Kleinpell,Derek C. Angus,Clifford S. Deutschman,Flávia Ribeiro Machado,Gordon D. Rubenfeld,Steven A R Webb,Richard Beale,Jean Louis Vincent,Rui Moreno +21 more
TL;DR: An update to the “Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock,” last published in 2008 is provided.
Journal ArticleDOI
The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine.
Jean Louis Vincent,R. Moreno,Jukka Takala,Sheila Willatts,A. de Mendonça,Hajo A. Bruining,C. K. Reinhart,P. M. Suter,L. G. Thijs +8 more
TL;DR: The ESICM developed a so-called sepsis-related organ failure assessment (SOFA) score to describe quantitatively and as objectively as possible the degree of organ dysfunction/failure over time in groups of patients or even in individual patients.
Journal ArticleDOI
2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference
Mitchell M. Levy,Mitchell P. Fink,John C. Marshall,Edward Abraham,Derek C. Angus,Deborah J. Cook,Jonathan M. Cohen,Steven M. Opal,Jean Louis Vincent,Graham Ramsay +9 more
TL;DR: This document reflects a process whereby a group of experts and opinion leaders revisited the 1992 sepsis guidelines and found that apart from expanding the list of signs and symptoms of sepsi to reflect clinical bedside experience, no evidence exists to support a change to the definitions.
Journal ArticleDOI
APACHE II-A Severity of Disease Classification System: Reply
TL;DR: The form and validation results of APACHE II, a severity of disease classification system, are presented, showing an increasing score was closely correlated with the subsequent risk of hospital death for 5815 intensive care admissions from 13 hospitals.
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Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012.
R. P. Dellinger,Mitchell M. Levy,Andrew Rhodes,Djillali Annane,Herwig Gerlach,Steven M. Opal,Jonathan E. Sevransky,Charles L. Sprung,Ivor S. Douglas,Roman Jaeschke,Tiffany M. Osborn,Mark E. Nunnally,Konrad Reinhart,Ruth M. Kleinpell,Derek C. Angus,Clifford S. Deutschman,Flávia Ribeiro Machado,Gordon D. Rubenfeld,Steven A R Webb,Richard Beale,Jean Louis Vincent,Rui Moreno +21 more