Autor según el artículo: 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;
Departamento: Medicina i Cirurgia
Autor/es de la URV: Bodi Saera, Maria Amparo / Magret Iglesias, Mònica / Rodríguez Oviedo, Alejandro Hugo
Palabras clave: 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
Resumen: 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.
Áreas temáticas: Critical care medicine Critical care and intensive care medicine
Acceso a la licencia de uso: https://creativecommons.org/licenses/by/3.0/es/
ISSN: 20520492
Direcció de correo del autor: alejandrohugo.rodriguez@urv.cat monica.magret@urv.cat mariaamparo.bodi@urv.cat mariaamparo.bodi@urv.cat
Identificador del autor: 0000-0001-8828-5984 0000-0002-9534-9920 0000-0001-7652-8379 0000-0001-7652-8379
Fecha de alta del registro: 2024-09-07
Versión del articulo depositado: info:eu-repo/semantics/publishedVersion
Enlace a la fuente original: https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-016-0129-4
URL Documento de licencia: https://repositori.urv.cat/ca/proteccio-de-dades/
Referencia al articulo segun fuente origial: Journal Of Intensive Care. 4 (7): 7-
Referencia de l'ítem segons les normes 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
DOI del artículo: 10.1186/s40560-016-0129-4
Entidad: Universitat Rovira i Virgili
Año de publicación de la revista: 2016
Tipo de publicación: Journal Publications
Repositori URV