Author, as appears in the article.: Claverias, Laura; Mari, Michael; Marin-Corral, Judith; Magret, Monica; Trefler, Sandra; Bodi, Maria; Garcia-Espana, Antonio; Carlos Yebenes, Juan; Pascual, Sergi; Gea, Joaquim; Rodriguez, Alejandro;
Department: Medicina i Cirurgia
URV's Author/s: Bodi Saera, Maria Amparo / Magret Iglesias, Mònica / Rodríguez Oviedo, Alejandro Hugo
Keywords: Tissue oxygenation Therapy Systemic cytokine levels Severe sepsis Septic shock Sepsis Neumonía comunitaria grave Near-infrared spectroscopy Mortality Microcirculation Microcirculación Intensive-care-unit Impact Community-acquired pneumonia
Abstract: Background: Community-acquired pneumonia (CAP) mortality exceeds 20 % in critical care patients despite appropriate antibiotic therapy. Regional tissue oxygen saturation index (rSO2) measured with near-infrared spectroscopy (NIRS) might facilitate early detection for patients at risk of serious complications. Our objectives were to determine the relationship between early determination of rSO2 and mortality and to compare discrimination power for mortality of rSO2 and other resuscitation variables in critically ill CAP patients.
Methods: This is a prospective observational study. Patients with CAP were enrolled within 6 h to intensive care admission. Demographics and clinical variables were recorded. rSO2 was determined using NIRS in brachioradialis muscle. All variables were determined at baseline and 24 h after admission.
Results: Forty patients were enrolled. Fourteen patients (35 %) had a baseline rSO2 < 60 % and 7 of them died (50 %). Only 1 of 26 (3.8 %) patients with rSO2 >= 60 % died (p = 0.007). The area under ROC curve (AUROC) showed consistent mortality discrimination at baseline (0.84, p = 0.03) and at 24 h (0.86, p = 0.006) for rSO2 values. Cox regression analysis showed that low rSO2 at ICU admission (hazard ratio (HR) = 8.99; 95 % confidence interval (CI) 1.05-76.8; p = 0.045) and low rSO2 at 24 h (HR = 13.18; 95 % CI 1.52-113.6; p = 0.019) were variables independently associated with mortality. In contrast, other variables such as Acute Physiology and Chronic Health Evaluation (APACHE II) score (HR = 1.09; 95 % CI 0.99-1.19; p = 0.052) were not associated with mortality.
Conclusions: Our findings suggest that forearm skeletal muscle rSO2 differs in patients with severe CAP according to outcome and might be an early prognosis tool.
Thematic Areas: Critical care medicine Critical care and intensive care medicine
licence for use: https://creativecommons.org/licenses/by/3.0/es/
ISSN: 20520492
Author's mail: alejandrohugo.rodriguez@urv.cat monica.magret@urv.cat mariaamparo.bodi@urv.cat mariaamparo.bodi@urv.cat
Author identifier: 0000-0001-8828-5984 0000-0002-9534-9920 0000-0001-7652-8379 0000-0001-7652-8379
Record's date: 2024-09-07
Papper version: info:eu-repo/semantics/publishedVersion
Link to the original source: https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-016-0129-4
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Papper original source: Journal Of Intensive Care. 4 (7): 7-
APA: Claverias, Laura; Mari, Michael; Marin-Corral, Judith; Magret, Monica; Trefler, Sandra; Bodi, Maria; Garcia-Espana, Antonio; Carlos Yebenes, Juan; Pas (2016). The prognostic value of muscle regional oxygen saturation index in severe community-acquired pneumonia: a prospective observational study. Journal Of Intensive Care, 4(7), 7-. DOI: 10.1186/s40560-016-0129-4
Article's DOI: 10.1186/s40560-016-0129-4
Entity: Universitat Rovira i Virgili
Journal publication year: 2016
Publication Type: Journal Publications
Repositori URV