Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers
To characterize the microvascular effects of a brief period of hyperoxia, in patients with septic shock and in healthy volunteers. In 20 patients with septic shock, we assessed systemic hemodynamics, sublingual microcirculation by SDF-videomicroscopy, and skin perfusion by capillary refill time (CRT...
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Veröffentlicht in: | Journal of critical care 2019-10, Vol.53, p.62-68 |
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creator | Valenzuela Espinoza, Emilio Daniel Pozo, Mario Omar Kanoore Edul, Vanina Siham Furche, Mariano Motta, María Fernanda Risso Vazquez, Alejandro Rubatto Birri, Paolo Nahuel Dubin, Arnaldo |
description | To characterize the microvascular effects of a brief period of hyperoxia, in patients with septic shock and in healthy volunteers.
In 20 patients with septic shock, we assessed systemic hemodynamics, sublingual microcirculation by SDF-videomicroscopy, and skin perfusion by capillary refill time (CRT), central-peripheral temperature (ΔT°), and perfusion index. Measurements were performed at baseline and after 5 min of inspired oxygen fraction of 1.00. Additionally, we studied 8 healthy volunteers, in whom hyperoxia was prolonged to 30 min.
In septic patients, hyperoxia increased mean arterial pressure and systemic vascular resistance, but cardiac output remained unchanged. The only significant change in sublingual microcirculation was a decreased heterogeneity flow index (1.03 [1.01–1.07] vs 1.01 [0.34–1.05], P = .002). Perfused vascular density (13.1 [12.0–15.0] vs 14.0 [12.2–14.8] mm/mm2, P = .21) and the other sublingual microvascular variables were unmodified. CRT and ΔT° did not change but perfusion index slightly decreased. In healthy volunteers, sublingual microcirculation and skin perfusion were stable.
Short-term hyperoxia induced systemic cardiovascular changes but was not associated with noticeable derangement in sublingual microcirculation and skin perfusion. Nevertheless, longer exposures to hyperoxia might have produced different results.
•In septic shock, short-term hyperoxia increased systemic vascular resistance.•Sublingual microcirculation was unaffected by hyperoxia.•Concerning skin perfusion, only perfusion index was significantly decreased.•Since vascular resistance increased, ischemia might be present in other territories.•In volunteers, a longer hyperoxic exposure did not alter sublingual microcirculation. |
doi_str_mv | 10.1016/j.jcrc.2019.05.021 |
format | Article |
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In 20 patients with septic shock, we assessed systemic hemodynamics, sublingual microcirculation by SDF-videomicroscopy, and skin perfusion by capillary refill time (CRT), central-peripheral temperature (ΔT°), and perfusion index. Measurements were performed at baseline and after 5 min of inspired oxygen fraction of 1.00. Additionally, we studied 8 healthy volunteers, in whom hyperoxia was prolonged to 30 min.
In septic patients, hyperoxia increased mean arterial pressure and systemic vascular resistance, but cardiac output remained unchanged. The only significant change in sublingual microcirculation was a decreased heterogeneity flow index (1.03 [1.01–1.07] vs 1.01 [0.34–1.05], P = .002). Perfused vascular density (13.1 [12.0–15.0] vs 14.0 [12.2–14.8] mm/mm2, P = .21) and the other sublingual microvascular variables were unmodified. CRT and ΔT° did not change but perfusion index slightly decreased. In healthy volunteers, sublingual microcirculation and skin perfusion were stable.
Short-term hyperoxia induced systemic cardiovascular changes but was not associated with noticeable derangement in sublingual microcirculation and skin perfusion. Nevertheless, longer exposures to hyperoxia might have produced different results.
•In septic shock, short-term hyperoxia increased systemic vascular resistance.•Sublingual microcirculation was unaffected by hyperoxia.•Concerning skin perfusion, only perfusion index was significantly decreased.•Since vascular resistance increased, ischemia might be present in other territories.•In volunteers, a longer hyperoxic exposure did not alter sublingual microcirculation.</description><identifier>ISSN: 0883-9441</identifier><identifier>EISSN: 1557-8615</identifier><identifier>DOI: 10.1016/j.jcrc.2019.05.021</identifier><identifier>PMID: 31202159</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood pressure ; Heart rate ; Hemodynamics ; Hemoglobin ; Hyperoxia ; Intensive care ; Mortality ; Observational studies ; Sepsis ; Septic shock ; Skin perfusion ; Software ; Sublingual microcirculation ; Systematic review ; Variables ; Ventilators</subject><ispartof>Journal of critical care, 2019-10, Vol.53, p.62-68</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><rights>2019. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-3922541e6066bc9bd38d1cfefc1e59f421e362df3fdf03dc65347c12dd7285ff3</citedby><cites>FETCH-LOGICAL-c384t-3922541e6066bc9bd38d1cfefc1e59f421e362df3fdf03dc65347c12dd7285ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0883944119303612$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31202159$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Valenzuela Espinoza, Emilio Daniel</creatorcontrib><creatorcontrib>Pozo, Mario Omar</creatorcontrib><creatorcontrib>Kanoore Edul, Vanina Siham</creatorcontrib><creatorcontrib>Furche, Mariano</creatorcontrib><creatorcontrib>Motta, María Fernanda</creatorcontrib><creatorcontrib>Risso Vazquez, Alejandro</creatorcontrib><creatorcontrib>Rubatto Birri, Paolo Nahuel</creatorcontrib><creatorcontrib>Dubin, Arnaldo</creatorcontrib><title>Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers</title><title>Journal of critical care</title><addtitle>J Crit Care</addtitle><description>To characterize the microvascular effects of a brief period of hyperoxia, in patients with septic shock and in healthy volunteers.
In 20 patients with septic shock, we assessed systemic hemodynamics, sublingual microcirculation by SDF-videomicroscopy, and skin perfusion by capillary refill time (CRT), central-peripheral temperature (ΔT°), and perfusion index. Measurements were performed at baseline and after 5 min of inspired oxygen fraction of 1.00. Additionally, we studied 8 healthy volunteers, in whom hyperoxia was prolonged to 30 min.
In septic patients, hyperoxia increased mean arterial pressure and systemic vascular resistance, but cardiac output remained unchanged. The only significant change in sublingual microcirculation was a decreased heterogeneity flow index (1.03 [1.01–1.07] vs 1.01 [0.34–1.05], P = .002). Perfused vascular density (13.1 [12.0–15.0] vs 14.0 [12.2–14.8] mm/mm2, P = .21) and the other sublingual microvascular variables were unmodified. CRT and ΔT° did not change but perfusion index slightly decreased. In healthy volunteers, sublingual microcirculation and skin perfusion were stable.
Short-term hyperoxia induced systemic cardiovascular changes but was not associated with noticeable derangement in sublingual microcirculation and skin perfusion. Nevertheless, longer exposures to hyperoxia might have produced different results.
•In septic shock, short-term hyperoxia increased systemic vascular resistance.•Sublingual microcirculation was unaffected by hyperoxia.•Concerning skin perfusion, only perfusion index was significantly decreased.•Since vascular resistance increased, ischemia might be present in other territories.•In volunteers, a longer hyperoxic exposure did not alter sublingual microcirculation.</description><subject>Blood pressure</subject><subject>Heart rate</subject><subject>Hemodynamics</subject><subject>Hemoglobin</subject><subject>Hyperoxia</subject><subject>Intensive care</subject><subject>Mortality</subject><subject>Observational studies</subject><subject>Sepsis</subject><subject>Septic shock</subject><subject>Skin perfusion</subject><subject>Software</subject><subject>Sublingual microcirculation</subject><subject>Systematic review</subject><subject>Variables</subject><subject>Ventilators</subject><issn>0883-9441</issn><issn>1557-8615</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kctu1DAUhi0EokPhBVggS2xYNMGXOJOgbqqqXKRKbGBtZexj4pDYwXaG5p14SJxOYcECeeHb9__HPj9CLykpKaH126EcVFAlI7QtiSgJo4_QjgqxL5qaisdoR5qGF21V0TP0LMaBELrnXDxFZ5yyTIt2h37dGAMqRewNjr0PqUgQJtyvMwR_ZzvsHY5rgskq3MPk9eq6vI4X2N-t38DhFDoX5yy8wJ3TON8Fr2xQy9gl6907fOWwP0QIx_t9N-KYFr1i6_CcT8Dl2j9t6nGEOeUi-RHq-71VD92Y-hUf_bi4BBDic_TEdGOEFw_zOfr6_ubL9cfi9vOHT9dXt4XiTZUK3jImKgo1qeuDag-aN5oqA0ZREK2pGAVeM2240YZwrWrBq72iTOs9a4Qx_By9OfnOwf9YICY52ahgHDsHfomSsYo1lIqKZ_T1P-jgl5C_uVH1fhukyRQ7Ubk5MQYwcg526sIqKZFblnKQW5Zyy1ISIXM6WfTqwXo5TKD_Sv6El4HLEwC5F0cLQUaVG6pA25Azldrb__n_BunctIE</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Valenzuela Espinoza, Emilio Daniel</creator><creator>Pozo, Mario Omar</creator><creator>Kanoore Edul, Vanina Siham</creator><creator>Furche, Mariano</creator><creator>Motta, María Fernanda</creator><creator>Risso Vazquez, Alejandro</creator><creator>Rubatto Birri, Paolo Nahuel</creator><creator>Dubin, Arnaldo</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201910</creationdate><title>Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers</title><author>Valenzuela Espinoza, Emilio Daniel ; 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In 20 patients with septic shock, we assessed systemic hemodynamics, sublingual microcirculation by SDF-videomicroscopy, and skin perfusion by capillary refill time (CRT), central-peripheral temperature (ΔT°), and perfusion index. Measurements were performed at baseline and after 5 min of inspired oxygen fraction of 1.00. Additionally, we studied 8 healthy volunteers, in whom hyperoxia was prolonged to 30 min.
In septic patients, hyperoxia increased mean arterial pressure and systemic vascular resistance, but cardiac output remained unchanged. The only significant change in sublingual microcirculation was a decreased heterogeneity flow index (1.03 [1.01–1.07] vs 1.01 [0.34–1.05], P = .002). Perfused vascular density (13.1 [12.0–15.0] vs 14.0 [12.2–14.8] mm/mm2, P = .21) and the other sublingual microvascular variables were unmodified. CRT and ΔT° did not change but perfusion index slightly decreased. In healthy volunteers, sublingual microcirculation and skin perfusion were stable.
Short-term hyperoxia induced systemic cardiovascular changes but was not associated with noticeable derangement in sublingual microcirculation and skin perfusion. Nevertheless, longer exposures to hyperoxia might have produced different results.
•In septic shock, short-term hyperoxia increased systemic vascular resistance.•Sublingual microcirculation was unaffected by hyperoxia.•Concerning skin perfusion, only perfusion index was significantly decreased.•Since vascular resistance increased, ischemia might be present in other territories.•In volunteers, a longer hyperoxic exposure did not alter sublingual microcirculation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31202159</pmid><doi>10.1016/j.jcrc.2019.05.021</doi><tpages>7</tpages></addata></record> |
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subjects | Blood pressure Heart rate Hemodynamics Hemoglobin Hyperoxia Intensive care Mortality Observational studies Sepsis Septic shock Skin perfusion Software Sublingual microcirculation Systematic review Variables Ventilators |
title | Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers |
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