dc.creator | Chalkias A., Laou E., Mermiri M., Michou A., Ntalarizou N., Koutsona S., Chasiotis G., Garoufalis G., Agorogiannis V., Kyriakaki A., Papagiannakis N. | en |
dc.date.accessioned | 2023-01-31T07:42:34Z | |
dc.date.available | 2023-01-31T07:42:34Z | |
dc.date.issued | 2022 | |
dc.identifier | 10.1007/s00068-022-01991-2 | |
dc.identifier.issn | 18639933 | |
dc.identifier.uri | http://hdl.handle.net/11615/72432 | |
dc.description.abstract | Purpose: Severe sepsis and septic shock may impair microcirculatory perfusion and cause organ dysfunction. The aim of this pilot study was to assess a new microcirculation-guided resuscitation strategy in patients with septic shock undergoing emergency abdominal surgery. Methods: A microcirculation-guided treatment algorithm was developed and applied intraoperatively following restoration of systemic hemodynamics. Sublingual microcirculation was monitored with Sidestream DarkField (SDF +) imaging technique. The primary objective was to investigate the change in De Backer score, Consensus Proportion of Perfused Vessels (Consensus PPV), and Consensus PPV (small) and its association with venous-to-arterial carbon dioxide difference (v-aPCO2). Results: Thirteen consecutive patients were included in the study. Microcirculation-guided resuscitation resulted in an increase of 0.49 mm−1 in the De Backer score (p < 0.001), an increase of 2.28% in the Consensus PPV (p < 0.001), and an increase of 2.26% in the Consensus PPV (small) (p < 0.001) for every 30 min of additional intraoperative time. All microcirculation variables were negatively correlated with v-aPCO2 (rho = − 0.656, adj-p < 0.001; rho = − 0.623; adj-p < 0.001; rho = − 0.597, adj-p < 0.001, respectively) at each intraoperative time point. Lactate levels were negatively correlated with Consensus PPV (rho = − 0.464; adj-p = 0.002) and Consensus PPV (small) (rho = − 0.391, adj-p < 0.001). Survival at 30 days, 90 days, and 1 year were 76.9%, 76.9%, and 61.5%, respectively. Conclusions: The intraoperative use of microcirculation-guided resuscitation strategy may improve tissue perfusion and hemodynamic coherence in patients with septic shock. © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany. | en |
dc.language.iso | en | en |
dc.source | European Journal of Trauma and Emergency Surgery | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85130584864&doi=10.1007%2fs00068-022-01991-2&partnerID=40&md5=b4e847ae398a33ff9eec8b81c0eed403 | |
dc.subject | hemodynamics | en |
dc.subject | human | en |
dc.subject | microcirculation | en |
dc.subject | perfusion | en |
dc.subject | pilot study | en |
dc.subject | septic shock | en |
dc.subject | Hemodynamics | en |
dc.subject | Humans | en |
dc.subject | Microcirculation | en |
dc.subject | Perfusion | en |
dc.subject | Pilot Projects | en |
dc.subject | Shock, Septic | en |
dc.subject | Springer Science and Business Media Deutschland GmbH | en |
dc.title | Microcirculation-guided treatment improves tissue perfusion and hemodynamic coherence in surgical patients with septic shock | en |
dc.type | journalArticle | en |