Intensive Care Medicine

, Volume 32, Issue 1, pp 87–92

Changes in muscle tissue oxygenation during stagnant ischemia in septic patients

  • Roman Parežnik
  • Rajko Knezevic
  • Gorazd Voga
  • Matej Podbregar
Original

DOI: 10.1007/s00134-005-2841-8

Cite this article as:
Parežnik, R., Knezevic, R., Voga, G. et al. Intensive Care Med (2006) 32: 87. doi:10.1007/s00134-005-2841-8

Abstract

Objective

To determine changes in the rate of thenar muscles tissue deoxygenation during stagnant ischemia in patients with severe sepsis and septic shock.

Design and setting

Prospective observational study in the medical ICU of a general hospital.

Patients and participants

Consecutive patients admitted to ICU with septic shock (n=6), severe sepsis (n=6), localized infection (n=3), and healthy volunteers (n=15).

Interventions

Upper limb ischemia was induced by rapid automatic pneumatic cuff inflation around upper arm.

Measurements and results

Thenar muscle tissue oxygen saturation (StO2) was measured continuously by near-infrared spectroscopy before and during upper limb ischemia. StO2 before intervention was comparable in patients with septic shock, severe sepsis, or localized infection and healthy volunteers (89 [65, 92]% vs. 82 [72, 91]% vs. 87 [85, 92]% vs. 83 [79, 93]%, respectively; p>0.1). The rate of StO2 decrease during stagnant ischemia after initial hemodynamic stabilization was slower in septic shock patients than in those with severe sepsis or localized infection and in controls (–7.0 [–3.6, –11.0] %/min vs. –10.4 [–7.8, –13.3] %/min vs. –19.5 [–12.3, –23.3] vs. –37.4 [–27.3, –56.2] %/min, respectively; p=0.041). At ICU discharge the rate of StO2 decrease did not differ between the septic shock, severe sepsis, and localized infection groups (–17.0 [–9.3, –28.9] %/min vs. –19.9 [–13.3, –23.6] %/min vs. –23.1 [–20.7, –26.2] %/min, respectively), but remained slower than in controls (p<0.01). The rate of StO2 decrease was correlated with Sequential Organ Failure Assessment (SOFA) score (r=0.739, p<0.001).

Conclusions

After hemodynamic stabilization thenar muscle tissue oxygen saturation during stagnant ischemia decreases slower in septic shock patients than in patients with severe sepsis or localized infection and in healthy volunteers. During ICU stay and improvement of sepsis the muscle tissue deoxygenation rate increases in survivors of both septic shock and severe sepsis and was correlated with SOFA score.

Keywords

Skeletal muscle oxygenation Oxygen consumption Sepsis Near-infrared spectroscopy 

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Roman Parežnik
    • 1
  • Rajko Knezevic
    • 1
  • Gorazd Voga
    • 1
  • Matej Podbregar
    • 2
  1. 1.Department of Intensive Internal MedicineGeneral HospitalCeljeSlovenia
  2. 2.Clinical Center for Intensive Care MedicineUniversity Medical CenterLjubljanaSlovenia

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