Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Institucional da FIOCRUZ (ARCA) |
Texto Completo: | https://www.arca.fiocruz.br/handle/icict/60731 |
Resumo: | Universidade Federal do Paraná. Hospital das Clínicas. Departamento de Medicina Interna. Curitiba, PR, Brasil. |
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Miranda, Ana Carolina deStefani, Fernanda do Carmo deVesco, Bruna Cassia DalCarraro Júnior, HipólitoAssreuy, JamilMorello, Luis GustavoMenezes, Igor Alexandre Cortês de2023-10-06T18:18:09Z2023-10-06T18:18:09Z2023MIRANDA, Ana Carolina de et al. Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study. Crit Care Sci. v. 35, n. 2, p. 177-186, 2023.https://www.arca.fiocruz.br/handle/icict/60731porAssociação de Medicina Intensiva Brasileira - AMIBRelationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleUniversidade Federal do Paraná. Hospital das Clínicas. Departamento de Medicina Interna. Curitiba, PR, Brasil.Universidade Federal do Paraná. Hospital das Clínicas. Unidade de Terapia Intensiva. Curitiba, PR.Universidade Federal do Paraná. Hospital das Clínicas. Unidade de Terapia Intensiva. Curitiba, PR.Universidade Federal do Paraná. Hospital das Clínicas. Unidade de Terapia Intensiva. Curitiba, PR.Universidade Federal de Santa Catarina. Departamento de Farmacologia. Florianópolis, SC, Brasil.Fundação Oswaldo Cruz. Instituto Carlos Chagas. Curitiba, PR, Brasil.Universidade Federal do Paraná. Hospital das Clínicas. Departamento de Medicina Interna. Curitiba, PR, Brasil.To measure the prognostic value of peripheral ischemic microvascular reserve in the context of persistent sepsis-induced hyperlactatemia and measure its influence on the temporal dynamics of lactate and the strength of association between these variables. Methods: This post hoc analysis of the peripheral perfusion index/postocclusive reactive hyperemia trial, an observational cohort study that enrolled patients with sepsis who persisted with lactate levels ≥ 2mmol/L after fluid resuscitation (with or without shock). Peripheral ischemic microvascular reserve was evaluated using the association of the peripheral perfusion index and postocclusive reactive hyperemia techniques. The cut off point of ∆ peripheral perfusion index peak values (%) defined the groups with low (≤ 62%) and high peripheral ischemic microvascular reserve (> 62%). Results: A total of 108 consecutive patients with persistent sepsis-induced hyperlactatemia were studied. The high peripheral ischemic microvascular reserve group showed higher 28-day mortality. than the low peripheral ischemic microvascular reserve group (p < 0.01). The temporal dynamics of lactate within the first 48 hours showed a rapid decrease in lactate levels in the low peripheral ischemic microvascular reserve group (p < 0.01). However, this result was not reproduced in the linear mixed effects model. A weak correlation between peripheral ischemic microvascular reserve (%) and lactate level (mmol/L) was observed within the first 24 hours (r = 0.23; p < 0.05). Conclusion: The prognostic value of high peripheral ischemic microvascular reserve was confirmed in the context of persistent sepsis-induced hyperlactatemia. Although there was a weak positive correlation between peripheral ischemic microvascular reserve value and lactate level within the first 24 hours of sepsis diagnosis, the low peripheral ischemic microvascular reserve group appeared to have a faster decrease in lactate over the 48 hours of follow-up.SepsisMicrocirculationHyperemiaPerfusion IndexLactatePrognosisSepsisMicrocirculaciónHiperemiaÍndice de PerfusiónPronósticoSepsieMicrocirculationIschémieHyperhémieIndice de perfusionPronosticSepseMicrocirculaçãoIsquemiaHiperemiaÍndice de PerfusãoLactatoPrognósticoinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALccsci-35-02-0177.pdfccsci-35-02-0177.pdfapplication/pdf1055681https://www.arca.fiocruz.br/bitstream/icict/60731/2/ccsci-35-02-0177.pdff8faa8ddbaf5faec27298548557b8b63MD52LICENSElicense.txtlicense.txttext/plain; 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dc.title.en_US.fl_str_mv |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study |
title |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study |
spellingShingle |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study Miranda, Ana Carolina de Sepsis Microcirculation Hyperemia Perfusion Index Lactate Prognosis Sepsis Microcirculación Hiperemia Índice de Perfusión Pronóstico Sepsie Microcirculation Ischémie Hyperhémie Indice de perfusion Pronostic Sepse Microcirculação Isquemia Hiperemia Índice de Perfusão Lactato Prognóstico |
title_short |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study |
title_full |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study |
title_fullStr |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study |
title_full_unstemmed |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study |
title_sort |
Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study |
author |
Miranda, Ana Carolina de |
author_facet |
Miranda, Ana Carolina de Stefani, Fernanda do Carmo de Vesco, Bruna Cassia Dal Carraro Júnior, Hipólito Assreuy, Jamil Morello, Luis Gustavo Menezes, Igor Alexandre Cortês de |
author_role |
author |
author2 |
Stefani, Fernanda do Carmo de Vesco, Bruna Cassia Dal Carraro Júnior, Hipólito Assreuy, Jamil Morello, Luis Gustavo Menezes, Igor Alexandre Cortês de |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Miranda, Ana Carolina de Stefani, Fernanda do Carmo de Vesco, Bruna Cassia Dal Carraro Júnior, Hipólito Assreuy, Jamil Morello, Luis Gustavo Menezes, Igor Alexandre Cortês de |
dc.subject.en.en_US.fl_str_mv |
Sepsis Microcirculation Hyperemia Perfusion Index Lactate Prognosis |
topic |
Sepsis Microcirculation Hyperemia Perfusion Index Lactate Prognosis Sepsis Microcirculación Hiperemia Índice de Perfusión Pronóstico Sepsie Microcirculation Ischémie Hyperhémie Indice de perfusion Pronostic Sepse Microcirculação Isquemia Hiperemia Índice de Perfusão Lactato Prognóstico |
dc.subject.es.en_US.fl_str_mv |
Sepsis Microcirculación Hiperemia Índice de Perfusión Pronóstico |
dc.subject.fr.en_US.fl_str_mv |
Sepsie Microcirculation Ischémie Hyperhémie Indice de perfusion Pronostic |
dc.subject.decs.en_US.fl_str_mv |
Sepse Microcirculação Isquemia Hiperemia Índice de Perfusão Lactato Prognóstico |
description |
Universidade Federal do Paraná. Hospital das Clínicas. Departamento de Medicina Interna. Curitiba, PR, Brasil. |
publishDate |
2023 |
dc.date.accessioned.fl_str_mv |
2023-10-06T18:18:09Z |
dc.date.available.fl_str_mv |
2023-10-06T18:18:09Z |
dc.date.issued.fl_str_mv |
2023 |
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 |
MIRANDA, Ana Carolina de et al. Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study. Crit Care Sci. v. 35, n. 2, p. 177-186, 2023. |
dc.identifier.uri.fl_str_mv |
https://www.arca.fiocruz.br/handle/icict/60731 |
identifier_str_mv |
MIRANDA, Ana Carolina de et al. Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study. Crit Care Sci. v. 35, n. 2, p. 177-186, 2023. |
url |
https://www.arca.fiocruz.br/handle/icict/60731 |
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por |
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Associação de Medicina Intensiva Brasileira - AMIB |
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Associação de Medicina Intensiva Brasileira - AMIB |
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