Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock

Detalhes bibliográficos
Autor(a) principal: Penna, Guilherme Loures
Data de Publicação: 2013
Outros Autores: Fialho, Fernanda M., Kurtz, Pedro, Japiassú, André M., Kalichsztein, Marcelo, Nobre, Gustavo, Villela, Nivaldo Ribeiro, Bouskela, Eliete
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
DOI: 10.1016/j.jcrc.2013.03.012
Texto Completo: https://www.arca.fiocruz.br/handle/icict/35707
Resumo: André M. Japiassú. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
id CRUZ_51887ec0c6592e90e6f578f1df60b0dd
oai_identifier_str oai:www.arca.fiocruz.br:icict/35707
network_acronym_str CRUZ
network_name_str Repositório Institucional da FIOCRUZ (ARCA)
repository_id_str 2135
spelling Penna, Guilherme LouresFialho, Fernanda M.Kurtz, PedroJapiassú, André M.Kalichsztein, MarceloNobre, GustavoVillela, Nivaldo RibeiroBouskela, Eliete2019-09-20T12:47:00Z2019-09-20T12:47:00Z2013PENNA, Guilherme Loures et al. Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock. Journal of Critical Care, v. 28, p. 825-831, 2013.0883-9441https://www.arca.fiocruz.br/handle/icict/3570710.1016/j.jcrc.2013.03.012André M. Japiassú. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.2020-09-20State University of Rio de Janeiro. Biomedical Center. Laboratory for Clinical and Experimental Research on Vascular Biology. Rio de Janeiro, RJ, Brazil / Casa de Saúde São José. Intensive Care Unit. Rio de Janeiro, RJ, Brazil.State University of Rio de Janeiro. Biomedical Center. Laboratory for Clinical and Experimental Research on Vascular Biology. Rio de Janeiro, RJ, Brazil.Casa de Saúde São José. Intensive Care Unit. Rio de Janeiro, RJ, Brazil / State University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Casa de Saúde São José. Intensive Care Unit. Rio de Janeiro, RJ, Brazil / State University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Casa de Saúde São José. Intensive Care Unit. Rio de Janeiro, RJ, Brazil / State University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.Casa de Saúde São José. Intensive Care Unit. Rio de Janeiro, RJ, Brazil / State University of Rio de Janeiro. Rio de Janeiro, RJ, Brazil.State University of Rio de Janeiro. Biomedical Center. Laboratory for Clinical and Experimental Research on Vascular Biology. Rio de Janeiro, RJ, Brazil / State University of Rio de Janeiro. Pedro Ernesto University Hospital. Department of Surgery. Division of Anesthesiology. Rio de Janeiro, RJ, Brazil.State University of Rio de Janeiro. Biomedical Center. Laboratory for Clinical and Experimental Research on Vascular Biology. Rio de Janeiro, RJ, Brazil.Purpose: The goal of this study was to explore possible microcirculatory alterations by changing sedative infusion from propofol to midazolam in patients with septic shock. Materials and Methods: Patients (n = 16) were sedated with propofol during the first 24 hours after intubation, then with midazolam, following a predefined algorithm. Systemic hemodynamics, perfusion parameters, and microcirculation were assessed at 2 time points: just before stopping propofol and 30minutes after the start of midazolam infusion. Sublingual microcirculation was evaluated by sidestream dark-field imaging. Results: The microvascular flow index and the proportion of perfused small vessels were greater when patients were on midazolam than when on propofol infusion (2.8 [2.4-2.9] vs 2.3 [1.9-2.6] and 96.4%[93.7%-97.6%] vs 92.7% [88.3%-94.7%], respectively; Pb.005), and the flow heterogeneity index was greater with propofol than with midazolam use (0.49 [0.2-0.8] vs 0.19 [0.1-0.4],Pb.05). There were nosignificant changes in systemic hemodynamics and perfusion parameters either during propofol use orduring midazolam infusions. Data are presented as median (25th-75th percentiles). Conclusions: In this study, sublingual microcirculatory perfusion improved when the infusion was changed from propofol to midazolam in patients with septic shock. This observation could not be explained by changes in systemic hemodynamics.engElsevierChanging sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shockinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleMicrocirculationShockSepsisHypnotics and sedativesPropofolMidazolaminfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txttext/plain1748https://www.arca.fiocruz.br/bitstream/icict/35707/1/license.txt8a4605be74aa9ea9d79846c1fba20a33MD51ORIGINALve_Penna_Guilherme_etal_INI_2013.pdfve_Penna_Guilherme_etal_INI_2013.pdfapplication/pdf376299https://www.arca.fiocruz.br/bitstream/icict/35707/2/ve_Penna_Guilherme_etal_INI_2013.pdf4bd16839ab3951ead41f32ecc1186ed7MD52TEXTve_Penna_Guilherme_etal_INI_2013.pdf.txtve_Penna_Guilherme_etal_INI_2013.pdf.txtExtracted texttext/plain28865https://www.arca.fiocruz.br/bitstream/icict/35707/3/ve_Penna_Guilherme_etal_INI_2013.pdf.txtc6ea85033147e13487ad8c404fdeb1d8MD53icict/357072021-03-24 16:32:36.675oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352021-03-24T19:32:36Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
title Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
spellingShingle Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
Penna, Guilherme Loures
Microcirculation
Shock
Sepsis
Hypnotics and sedatives
Propofol
Midazolam
title_short Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
title_full Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
title_fullStr Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
title_full_unstemmed Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
title_sort Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock
author Penna, Guilherme Loures
author_facet Penna, Guilherme Loures
Fialho, Fernanda M.
Kurtz, Pedro
Japiassú, André M.
Kalichsztein, Marcelo
Nobre, Gustavo
Villela, Nivaldo Ribeiro
Bouskela, Eliete
author_role author
author2 Fialho, Fernanda M.
Kurtz, Pedro
Japiassú, André M.
Kalichsztein, Marcelo
Nobre, Gustavo
Villela, Nivaldo Ribeiro
Bouskela, Eliete
author2_role author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Penna, Guilherme Loures
Fialho, Fernanda M.
Kurtz, Pedro
Japiassú, André M.
Kalichsztein, Marcelo
Nobre, Gustavo
Villela, Nivaldo Ribeiro
Bouskela, Eliete
dc.subject.en.pt_BR.fl_str_mv Microcirculation
Shock
Sepsis
Hypnotics and sedatives
Propofol
Midazolam
topic Microcirculation
Shock
Sepsis
Hypnotics and sedatives
Propofol
Midazolam
description André M. Japiassú. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento.
publishDate 2013
dc.date.issued.fl_str_mv 2013
dc.date.accessioned.fl_str_mv 2019-09-20T12:47:00Z
dc.date.available.fl_str_mv 2019-09-20T12:47:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv PENNA, Guilherme Loures et al. Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock. Journal of Critical Care, v. 28, p. 825-831, 2013.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/35707
dc.identifier.issn.pt_BR.fl_str_mv 0883-9441
dc.identifier.doi.none.fl_str_mv 10.1016/j.jcrc.2013.03.012
identifier_str_mv PENNA, Guilherme Loures et al. Changing sedative infusion from propofol to midazolam improves sublingual microcirculatory perfusion in patients with septic shock. Journal of Critical Care, v. 28, p. 825-831, 2013.
0883-9441
10.1016/j.jcrc.2013.03.012
url https://www.arca.fiocruz.br/handle/icict/35707
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/35707/1/license.txt
https://www.arca.fiocruz.br/bitstream/icict/35707/2/ve_Penna_Guilherme_etal_INI_2013.pdf
https://www.arca.fiocruz.br/bitstream/icict/35707/3/ve_Penna_Guilherme_etal_INI_2013.pdf.txt
bitstream.checksum.fl_str_mv 8a4605be74aa9ea9d79846c1fba20a33
4bd16839ab3951ead41f32ecc1186ed7
c6ea85033147e13487ad8c404fdeb1d8
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv repositorio.arca@fiocruz.br
_version_ 1822791440367878144

Registros relacionados