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
Sodium Thiosulfate Improves Intestinal and Hepatic Microcirculation Without Affecting Mitochondrial Function in Experimental Sepsis.
Jan Schulz,Sandra Kramer,Yasin Kanatli,Anne Kuebart,Inge Bauer,Olaf Picker,Christian Vollmer,Richard Truse,Anna Herminghaus +8 more
TL;DR: In this paper, the authors tested the hypothesis that sodium thiosulfate (STS), an inducer of endogenous H2S, improves intestinal and hepatic microcirculation and mitochondrial function via K(ATP)-channels in sepsis.
Dissertation
Vitamin C status, oxidative stress, hyperglycaemia and endothelial function in critically ill patients with septic shock : an observational study
TL;DR: It is demonstrated that low vitamin C status and oxidative stress persisted up to seven days after the resolution of septic shock; and both of these factors correlated positively with the severity of organ dysfunction.
Journal ArticleDOI
Sub-therapeutic vasopressin but not therapeutic vasopressin improves gastrointestinal microcirculation in septic rats: A randomized, placebo-controlled, blinded trial.
TL;DR: In this paper, the effect of sub-therapeutic and therapeutic vasopressin on gastrointestinal microcirculation in sepsis was investigated in 40 male Wistar rats.
Journal ArticleDOI
Conjunctival Microcirculation Is Associated with Cerebral Cortex Microcirculation in Post‐Resuscitation Mild Hypothermia: A Rat Model
TL;DR: This study aimed to compare the changes in sublingual and conjunctival micro Circulation occurring with cerebral cortex microcirculation changes during mild hypothermia in a rat model of cardiac arrest.
Journal ArticleDOI
Effects of Fluids on the Sublingual Microcirculation in Sepsis
TL;DR: A systematic review of the evidence for using handheld intra vital microscopes to guide fluid resuscitation and the effect of fluid bolus on the sublingual microcirculation in patients with sepsis and septic shock is presented in this paper .
References
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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.
Related Papers (5)
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