异丙肾上腺素输注与感染性休克中的微循环

Isoproterenol infusion and microcirculation in septic shock.

作者信息

Wiramus S, Textoris J, Bardin R, Vigne C, Kelway C, Martin C, Leone M

机构信息

Service d'anesthésie et de réanimation, Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Marseille, France.

出版信息

Heart Lung Vessel. 2014;6(4):274-9.

PMID:25436209

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4246846/

Abstract

INTRODUCTION

Our study primarily aimed at investigating the effect of isoproterenol infusion on tissue oxygen saturation in patients with septic shock. The secondary aim was to assess the relation between cardiac index, central venous oxygen saturation and tissue oxygen saturation.

METHODS

This retrospective study was conducted from December 2010 to March 2012. We included 14 consecutive patients with septic shock treated with isoproterenol. All patients were monitored by cardiac index and tissue oxygen saturation. From medical charts, routine hemodynamic data were extracted one hour before and six hours after the onset of isoproterenol infusion.

RESULTS

From baseline to H6, tissue oxygen saturation levels rise from 78 [72-82]% to 85 [78-88]% (p = 0.03). Isoproterenol infusion was associated with an increase of central venous oxygen saturation (from 67 [65-74]% to 84 [77-86]%, p = 0.02) and cardiac index (from 2.9 [2.7-3.1] L/min/m² to 3.9 [3.0-4.4] L/min/m², p = 0.006). Tissue oxygen saturation was correlated neither to cardiac index (p = 0.14, R(2) = 0.08) nor to central venous oxygen saturation (p = 0.19, R(2) = 0.10).

CONCLUSIONS

Use of isoproterenol was associated with an increase of tissue oxygen saturation. This increase was not correlated to cardiac index, suggesting a decoupling between macrocirculation and microcirculation.

摘要

引言

我们的研究主要旨在调查异丙肾上腺素输注对感染性休克患者组织氧饱和度的影响。次要目的是评估心脏指数、中心静脉血氧饱和度与组织氧饱和度之间的关系。

方法

这项回顾性研究于2010年12月至2012年3月进行。我们纳入了14例连续接受异丙肾上腺素治疗的感染性休克患者。所有患者均接受心脏指数和组织氧饱和度监测。从病历中提取异丙肾上腺素输注开始前1小时和开始后6小时的常规血流动力学数据。

结果

从基线到H6，组织氧饱和度水平从78[72 - 82]%升至85[78 - 88]%（p = 0.03）。异丙肾上腺素输注与中心静脉血氧饱和度升高（从67[65 - 74]%升至84[77 - 86]%，p = 0.02）和心脏指数升高（从2.9[2.7 - 3.1]L/min/m²升至3.9[3.0 - 4.4]L/min/m²，p = 0.006）相关。组织氧饱和度与心脏指数（p = 0.14，R(2)=0.08）和中心静脉血氧饱和度（p = 0.19，R(2)=0.10）均无相关性。