Gastroduodenal perfusion and mortality in mechanical ventilation-dependent patients with systemic inflammatory response syndrome
The role of gastrointestinal blood flow determination in predicting mortality is not known. We tested the hypothesis that when mechanical ventilation-dependent (MVD) patients with systemic inflammatory response syndrome (SIRS) develop a significant reduction in gastroduodenal blood flow, high mortal...
Gespeichert in:
| Veröffentlicht in: | Digestive diseases and sciences 2004-06, Vol.49 (6), p.906-913 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 913 |
|---|---|
| container_issue | 6 |
| container_start_page | 906 |
| container_title | Digestive diseases and sciences |
| container_volume | 49 |
| creator | SPIRT, Mitchell J GUTH, Paul H RANDALL, Gayle LEUNG, Felix W |
| description | The role of gastrointestinal blood flow determination in predicting mortality is not known. We tested the hypothesis that when mechanical ventilation-dependent (MVD) patients with systemic inflammatory response syndrome (SIRS) develop a significant reduction in gastroduodenal blood flow, high mortality will ensue. The design was a prospective, observational study at the intensive care unit (study patients) and outpatient endoscopy suite (controls) of a tertiary care Veterans Affairs Hospital. There were 6 study patients and 10 control subjects. Interventions were endoscopic reflectance spectrophotometry recorded indexes of gastroduodenal mucosal oxygen saturation (ISO2) and hemoglobin concentration (IHB). Data for Acute Physiologic and Chronic Health Evaluation (APACHE) II scores were gathered. All study patients had septic SIRS at enrollment. Gastroduodenal blood flow measurements ranged from 32 to 55% (ISO2) and from 42 to 51% (IHB) of those in control subjects. The significant hypoperfusion upgraded diagnosis to severe sepsis. The APACHE II score of 16.8 +/- 2.8 (mean +/- SE) predicted approximately 25% mortality. Observed in-hospital mortality was 83%. Our study confirmed that MVD patients with severe sepsis have a significant impairment of gastroduodenal blood flow. Such a dramatic reduction is associated with a grave prognosis. The impact of these measurements on physicians' predictions of the likelihood of survival in patients receiving intensive care deserves to be assessed. |
| doi_str_mv | 10.1023/B:DDAS.0000034547.87812.74 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_66786401</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>21345182</sourcerecordid><originalsourceid>FETCH-LOGICAL-c455t-7ccaf91d0d3f4d462629c43258bb732904f7061337373d60ae8f02e09d0d91ef3</originalsourceid><addsrcrecordid>eNqFkU1rFTEUhoMo9lr9CzIUdDfXfE0y010_tAoFF-o65CYnNGUmGZNM5e7605uxFy64MVmckDzvCZwHoTOCtwRT9uny_Pr64scWr4vxjsttL3tCt5K_QBvSSdbSTvQv0QYTUc-EiBP0Juf7ig-SiNfohHQMD70UG_R4o3NJ0S7RQtBjM0NyS_YxNDrYZoqp6NGXfeNDM4G508GbSj1AKH7UpXKthRlCDZdmrhe15uaPL3dN3ucCkzc16kY9TbrEtG8S5DmGDPU52BQneIteOT1meHeop-jXl88_r762t99vvl1d3LaGd11ppTHaDcRiyxy3XFBBB8MZ7frdTjI6YO4kFoQxWbcVWEPvMAU81MRAwLFT9PG575zi7wVyUZPPBsZRB4hLVkLIXnBM_gtSUmdOelrBs3_A-7ikOsSV4Yx1QvAKnT9DJsWcEzg1Jz_ptFcEq9WmulSrTXW0qf7aVHINvz_8sOwmsMfoQV8FPhwAnasXl3QwPh85gRnpOGdPFJSrLg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>214335664</pqid></control><display><type>article</type><title>Gastroduodenal perfusion and mortality in mechanical ventilation-dependent patients with systemic inflammatory response syndrome</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>SPIRT, Mitchell J ; GUTH, Paul H ; RANDALL, Gayle ; LEUNG, Felix W</creator><creatorcontrib>SPIRT, Mitchell J ; GUTH, Paul H ; RANDALL, Gayle ; LEUNG, Felix W</creatorcontrib><description>The role of gastrointestinal blood flow determination in predicting mortality is not known. We tested the hypothesis that when mechanical ventilation-dependent (MVD) patients with systemic inflammatory response syndrome (SIRS) develop a significant reduction in gastroduodenal blood flow, high mortality will ensue. The design was a prospective, observational study at the intensive care unit (study patients) and outpatient endoscopy suite (controls) of a tertiary care Veterans Affairs Hospital. There were 6 study patients and 10 control subjects. Interventions were endoscopic reflectance spectrophotometry recorded indexes of gastroduodenal mucosal oxygen saturation (ISO2) and hemoglobin concentration (IHB). Data for Acute Physiologic and Chronic Health Evaluation (APACHE) II scores were gathered. All study patients had septic SIRS at enrollment. Gastroduodenal blood flow measurements ranged from 32 to 55% (ISO2) and from 42 to 51% (IHB) of those in control subjects. The significant hypoperfusion upgraded diagnosis to severe sepsis. The APACHE II score of 16.8 +/- 2.8 (mean +/- SE) predicted approximately 25% mortality. Observed in-hospital mortality was 83%. Our study confirmed that MVD patients with severe sepsis have a significant impairment of gastroduodenal blood flow. Such a dramatic reduction is associated with a grave prognosis. The impact of these measurements on physicians' predictions of the likelihood of survival in patients receiving intensive care deserves to be assessed.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1023/B:DDAS.0000034547.87812.74</identifier><identifier>PMID: 15309876</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>Heidelberg: Springer</publisher><subject>Aged ; APACHE ; Biological and medical sciences ; Case-Control Studies ; Duodenum - blood supply ; Feeding. Feeding behavior ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Gastroenterology. Liver. Pancreas. Abdomen ; Hospital Mortality ; Humans ; Intestinal Mucosa - blood supply ; Medical sciences ; Metabolic diseases ; Middle Aged ; Predictive Value of Tests ; Prospective Studies ; Regional Blood Flow ; Respiration, Artificial ; Systemic Inflammatory Response Syndrome - mortality ; Systemic Inflammatory Response Syndrome - physiopathology ; Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><ispartof>Digestive diseases and sciences, 2004-06, Vol.49 (6), p.906-913</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright Kluwer Academic Publishers Jun 2004</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-7ccaf91d0d3f4d462629c43258bb732904f7061337373d60ae8f02e09d0d91ef3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=16031544$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15309876$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>SPIRT, Mitchell J</creatorcontrib><creatorcontrib>GUTH, Paul H</creatorcontrib><creatorcontrib>RANDALL, Gayle</creatorcontrib><creatorcontrib>LEUNG, Felix W</creatorcontrib><title>Gastroduodenal perfusion and mortality in mechanical ventilation-dependent patients with systemic inflammatory response syndrome</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><description>The role of gastrointestinal blood flow determination in predicting mortality is not known. We tested the hypothesis that when mechanical ventilation-dependent (MVD) patients with systemic inflammatory response syndrome (SIRS) develop a significant reduction in gastroduodenal blood flow, high mortality will ensue. The design was a prospective, observational study at the intensive care unit (study patients) and outpatient endoscopy suite (controls) of a tertiary care Veterans Affairs Hospital. There were 6 study patients and 10 control subjects. Interventions were endoscopic reflectance spectrophotometry recorded indexes of gastroduodenal mucosal oxygen saturation (ISO2) and hemoglobin concentration (IHB). Data for Acute Physiologic and Chronic Health Evaluation (APACHE) II scores were gathered. All study patients had septic SIRS at enrollment. Gastroduodenal blood flow measurements ranged from 32 to 55% (ISO2) and from 42 to 51% (IHB) of those in control subjects. The significant hypoperfusion upgraded diagnosis to severe sepsis. The APACHE II score of 16.8 +/- 2.8 (mean +/- SE) predicted approximately 25% mortality. Observed in-hospital mortality was 83%. Our study confirmed that MVD patients with severe sepsis have a significant impairment of gastroduodenal blood flow. Such a dramatic reduction is associated with a grave prognosis. The impact of these measurements on physicians' predictions of the likelihood of survival in patients receiving intensive care deserves to be assessed.</description><subject>Aged</subject><subject>APACHE</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Duodenum - blood supply</subject><subject>Feeding. Feeding behavior</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Intestinal Mucosa - blood supply</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>Middle Aged</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Regional Blood Flow</subject><subject>Respiration, Artificial</subject><subject>Systemic Inflammatory Response Syndrome - mortality</subject><subject>Systemic Inflammatory Response Syndrome - physiopathology</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkU1rFTEUhoMo9lr9CzIUdDfXfE0y010_tAoFF-o65CYnNGUmGZNM5e7605uxFy64MVmckDzvCZwHoTOCtwRT9uny_Pr64scWr4vxjsttL3tCt5K_QBvSSdbSTvQv0QYTUc-EiBP0Juf7ig-SiNfohHQMD70UG_R4o3NJ0S7RQtBjM0NyS_YxNDrYZoqp6NGXfeNDM4G508GbSj1AKH7UpXKthRlCDZdmrhe15uaPL3dN3ucCkzc16kY9TbrEtG8S5DmGDPU52BQneIteOT1meHeop-jXl88_r762t99vvl1d3LaGd11ppTHaDcRiyxy3XFBBB8MZ7frdTjI6YO4kFoQxWbcVWEPvMAU81MRAwLFT9PG575zi7wVyUZPPBsZRB4hLVkLIXnBM_gtSUmdOelrBs3_A-7ikOsSV4Yx1QvAKnT9DJsWcEzg1Jz_ptFcEq9WmulSrTXW0qf7aVHINvz_8sOwmsMfoQV8FPhwAnasXl3QwPh85gRnpOGdPFJSrLg</recordid><startdate>20040601</startdate><enddate>20040601</enddate><creator>SPIRT, Mitchell J</creator><creator>GUTH, Paul H</creator><creator>RANDALL, Gayle</creator><creator>LEUNG, Felix W</creator><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><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>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7QL</scope><scope>C1K</scope><scope>7X8</scope></search><sort><creationdate>20040601</creationdate><title>Gastroduodenal perfusion and mortality in mechanical ventilation-dependent patients with systemic inflammatory response syndrome</title><author>SPIRT, Mitchell J ; GUTH, Paul H ; RANDALL, Gayle ; LEUNG, Felix W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-7ccaf91d0d3f4d462629c43258bb732904f7061337373d60ae8f02e09d0d91ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aged</topic><topic>APACHE</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Duodenum - blood supply</topic><topic>Feeding. Feeding behavior</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Intestinal Mucosa - blood supply</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>Middle Aged</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Regional Blood Flow</topic><topic>Respiration, Artificial</topic><topic>Systemic Inflammatory Response Syndrome - mortality</topic><topic>Systemic Inflammatory Response Syndrome - physiopathology</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>SPIRT, Mitchell J</creatorcontrib><creatorcontrib>GUTH, Paul H</creatorcontrib><creatorcontrib>RANDALL, Gayle</creatorcontrib><creatorcontrib>LEUNG, Felix W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Environmental Sciences and Pollution Management</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>SPIRT, Mitchell J</au><au>GUTH, Paul H</au><au>RANDALL, Gayle</au><au>LEUNG, Felix W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gastroduodenal perfusion and mortality in mechanical ventilation-dependent patients with systemic inflammatory response syndrome</atitle><jtitle>Digestive diseases and sciences</jtitle><addtitle>Dig Dis Sci</addtitle><date>2004-06-01</date><risdate>2004</risdate><volume>49</volume><issue>6</issue><spage>906</spage><epage>913</epage><pages>906-913</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract>The role of gastrointestinal blood flow determination in predicting mortality is not known. We tested the hypothesis that when mechanical ventilation-dependent (MVD) patients with systemic inflammatory response syndrome (SIRS) develop a significant reduction in gastroduodenal blood flow, high mortality will ensue. The design was a prospective, observational study at the intensive care unit (study patients) and outpatient endoscopy suite (controls) of a tertiary care Veterans Affairs Hospital. There were 6 study patients and 10 control subjects. Interventions were endoscopic reflectance spectrophotometry recorded indexes of gastroduodenal mucosal oxygen saturation (ISO2) and hemoglobin concentration (IHB). Data for Acute Physiologic and Chronic Health Evaluation (APACHE) II scores were gathered. All study patients had septic SIRS at enrollment. Gastroduodenal blood flow measurements ranged from 32 to 55% (ISO2) and from 42 to 51% (IHB) of those in control subjects. The significant hypoperfusion upgraded diagnosis to severe sepsis. The APACHE II score of 16.8 +/- 2.8 (mean +/- SE) predicted approximately 25% mortality. Observed in-hospital mortality was 83%. Our study confirmed that MVD patients with severe sepsis have a significant impairment of gastroduodenal blood flow. Such a dramatic reduction is associated with a grave prognosis. The impact of these measurements on physicians' predictions of the likelihood of survival in patients receiving intensive care deserves to be assessed.</abstract><cop>Heidelberg</cop><pub>Springer</pub><pmid>15309876</pmid><doi>10.1023/B:DDAS.0000034547.87812.74</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0163-2116 |
| ispartof | Digestive diseases and sciences, 2004-06, Vol.49 (6), p.906-913 |
| issn | 0163-2116 1573-2568 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_66786401 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Aged APACHE Biological and medical sciences Case-Control Studies Duodenum - blood supply Feeding. Feeding behavior Follow-Up Studies Fundamental and applied biological sciences. Psychology Gastroenterology. Liver. Pancreas. Abdomen Hospital Mortality Humans Intestinal Mucosa - blood supply Medical sciences Metabolic diseases Middle Aged Predictive Value of Tests Prospective Studies Regional Blood Flow Respiration, Artificial Systemic Inflammatory Response Syndrome - mortality Systemic Inflammatory Response Syndrome - physiopathology Vertebrates: anatomy and physiology, studies on body, several organs or systems |
| title | Gastroduodenal perfusion and mortality in mechanical ventilation-dependent patients with systemic inflammatory response syndrome |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-04T11%3A08%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Gastroduodenal%20perfusion%20and%20mortality%20in%20mechanical%20ventilation-dependent%20patients%20with%20systemic%20inflammatory%20response%20syndrome&rft.jtitle=Digestive%20diseases%20and%20sciences&rft.au=SPIRT,%20Mitchell%20J&rft.date=2004-06-01&rft.volume=49&rft.issue=6&rft.spage=906&rft.epage=913&rft.pages=906-913&rft.issn=0163-2116&rft.eissn=1573-2568&rft.coden=DDSCDJ&rft_id=info:doi/10.1023/B:DDAS.0000034547.87812.74&rft_dat=%3Cproquest_cross%3E21345182%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=214335664&rft_id=info:pmid/15309876&rfr_iscdi=true |