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Author Hernandez, Glenn ♦ Boerma, E. Christiaan ♦ Dubin, Arnaldo ♦ Bruhn, Alejandro ♦ Koopmans, Matty ♦ Edul, Vanina Kanoore ♦ Ruiz, Carolina ♦ Castro, Ricardo ♦ Pozo, Mario Omar ♦ Pedreros, Cesar ♦ Veas, Enrique ♦ Fuentealba, Andrea ♦ Kattan, Eduardo ♦ Rovegno, Maximiliano ♦ Ince, Can
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Natural sciences & mathematics ♦ Chemistry & allied sciences ♦ Life sciences; biology ♦ Physiology & related subjects ♦ Biochemistry ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Human anatomy, cytology, histology ♦ Human physiology ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Stomatognathic System ♦ Anatomy ♦ Eukaryota ♦ Organisms ♦ Bacterial Infections and Mycoses ♦ Diseases ♦ Organic Chemicals ♦ Chemical Actions and Uses ♦ Chemicals and Drugs ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Circulatory and Respiratory Physiological Phenomena ♦ Biological Sciences ♦ Persons ♦ Persons ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Critical Care ♦ Lactates ♦ Blood ♦ Microcirculation ♦ Mouth Floor ♦ Blood Supply ♦ Shock, Septic ♦ Physiopathology ♦ Therapy ♦ Apache ♦ Adolescent ♦ Adult ♦ Aged ♦ Aged, 80 And Over ♦ Argentina ♦ Chi-square Distribution ♦ Chile ♦ Cross-sectional Studies ♦ Female ♦ Hemodynamics ♦ Physiology ♦ Humans ♦ Logistic Models ♦ Male ♦ Drug Effects ♦ Middle Aged ♦ Netherlands ♦ Norepinephrine ♦ Therapeutic Use ♦ Predictive Value Of Tests ♦ Retrospective Studies ♦ Statistics, Nonparametric ♦ Vasoconstrictor Agents ♦ Journal Article ♦ Multicenter Study
Abstract PURPOSE: The aims of this study are to determine the general relationship of perfused vessel density (PVD) to mortality and organ dysfunctions and to explore if patients in the lowest quartile of distribution for this parameter present a higher risk of bad outcome and to identify systemic hemodynamic and perfusion variables that enhances the probability of finding a severe underlying microvascular dysfunction. MATERIALS AND METHODS: This is a retrospective multicenter study including 122 septic shock patients participating in 7 prospective clinical trials on which at least 1 sublingual microcirculatory assessment was performed during early resuscitation. RESULTS: Perfused vessel density was significantly related to organ dysfunctions and mortality, but this effect was largely explained by patients in the lowest quartile of distribution for PVD (P = .037 [odds ratio {OR}, 8.7; 95% confidence interval {CI}, 1.14-66.78] for mortality). Hyperlactatemia (P < .026 [OR, 1.23; 95% CI, 1.03-1.47]) and high norepinephrine requirements (P < .019 [OR, 7.04; 95% CI, 1.38-35.89]) increased the odds of finding a severe microvascular dysfunction. CONCLUSIONS: Perfused vessel density is significantly related to organ dysfunctions and mortality in septic shock patients, particularly in patients exhibiting more severe abnormalities as represented by the lowest quartile of distribution for this parameter. The presence of hyperlactatemia and high norepinephrine requirements increases the odds of finding a severe underlying microvascular dysfunction during a sublingual microcirculatory assessment.
Spatial Coverage Netherlands ♦ Chile ♦ Argentina
Description Country affiliation: Netherlands
Author Affiliation: Hernandez G ( Department of Translational Physiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. glennguru@gmail.com)
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2013-08-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 28
Issue Number 4


Source: WHO-Global Index Medicus