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
More filters
Journal ArticleDOI
Intramuscular Exposure to a Lethal Dose of Ricin Toxin Leads to Endothelial Glycocalyx Shedding and Microvascular Flow Abnormality in Mice and Swine
Anita Sapoznikov,Yoav Gal,Yentl Evgy,Moshe Aftalion,Shahaf Katalan,Tamar Sabo,Chanoch Kronman,Reut Falach +7 more
TL;DR: In this article, it was shown that following intramuscular administration, ricin bound preferentially to the vasculature in both mice and swine, leading to coagulopathy and widespread hemorrhages.
Journal ArticleDOI
Seven unconfirmed ideas to improve future ICU practice.
John J. Marini,Daniel De Backer,Can Ince,Can Ince,Mervyn Singer,Frank van Haren,Frank van Haren,Frank van Haren,Martin Westphal,Paul E. Wischmeyer +9 more
TL;DR: This paper presents a wide-ranging set of unproven ‘out of the mainstream’ ideas of the FCCM faculty, each with a defensible rationale and holding clear implications for altering bedside management.
Journal ArticleDOI
Acute oxygen delivery changes in relation to cardiac index changes after bolus fluid treatment in critically ill patients: Results of an observational study.
Charalampos Pierrakos,Thomas Nguyen,Dimitrios Velissaris,Philippe Gottignies,Jacques Devriendt,Patrick M. Honore,David De Bels +6 more
Journal ArticleDOI
The effects of scopolamine on the survival time and microcirculation of septic shock rats
TL;DR: Scopolamine reduced the plasma and lung concentrations of specific cytokines, improved the function of the microcirculation and prolonged the survival time of rats with septic shock.
Journal ArticleDOI
Time of dissociation between microcirculation, macrocirculation, and lactate levels in a rabbit model of early endotoxemic shock.
TL;DR: Changes in microcirculatory perfusion precede changes in macrocirculation and lactate levels in a rabbit model of endotoxemia shock and are distinct in early-stage endotoxic shock.
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.
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