Panda Anshumalini, Revadi Gouroumourty, Sharma Jai P, Pakhare Abhijit, Singhai Abhishek, Joshi Rajnish, Saigal Saurabh
Department of General Medicine, AIIMS, Bhopal, Madhya Pradesh, India.
Department of Community and Family Medicine, AIIMS, Bhopal, Madhya Pradesh, India.
Indian J Crit Care Med. 2022 Mar;26(3):294-301. doi: 10.5005/jp-journals-10071-24110.
Microcirculatory derangement is the primary cause of organ dysfunction in patients with sepsis. Assessment of the microcirculation is usually done by means of indirect parameters (SvO transcutaneous PO serum lactate.) The aim of our study is to understand microcirculatory abnormalities in patients with sepsis by directly visualizing the tiny vessels using hand-held video microscopes (HVMs) and determining the role of this modality in the prediction of sepsis-related mortality.
A longitudinal prospective hospital-based study was carried out in medical ward and ICU of a tertiary care hospital. Patients admitted with the presumed infectious disease were included. Evaluation of sublingual microcirculation was done in these patients from Day 1 to Day 5 Clinical and laboratory variables and microcirculation variables were compared between patients with or without sepsis and between survivors and non-survivors of sepsis. Chi-square test for categorical and Student's -test or Wilcoxon rank-sum test for continuous variables were applied. Univariate and multivariate regression analyses were performed using the Cox-proportional hazard model.
On admission, microcirculation assessment measure, PPV (small), was significantly reduced in those with sepsis, as compared to those without sepsis. Multivariable models indicate the inverse relationship of PPV small with mortality.
Panda A, Revadi G, Sharma JP, Pakhare A, Singhai A, Joshi R, . On Admission, Microcirculation Abnormality is an Independent Predictor of Sepsis and Sepsis-related Mortality: A Hospital-based Study. Indian J Crit Care Med 2022;26(3):294-301.
微循环紊乱是脓毒症患者器官功能障碍的主要原因。微循环评估通常通过间接参数(混合静脉血氧饱和度、经皮氧分压、血清乳酸)进行。我们研究的目的是通过使用手持式视频显微镜(HVM)直接观察微小血管,了解脓毒症患者的微循环异常情况,并确定这种检查方式在预测脓毒症相关死亡率中的作用。
在一家三级医院的内科病房和重症监护病房开展了一项基于医院的纵向前瞻性研究。纳入疑似感染性疾病入院的患者。在这些患者入院第1天至第5天对其舌下微循环进行评估。比较脓毒症患者与非脓毒症患者以及脓毒症幸存者与非幸存者之间的临床和实验室变量以及微循环变量。分类变量采用卡方检验,连续变量采用学生t检验或Wilcoxon秩和检验。使用Cox比例风险模型进行单变量和多变量回归分析。
入院时,脓毒症患者的微循环评估指标PPV(小)较非脓毒症患者显著降低。多变量模型表明PPV小与死亡率呈负相关。
Panda A, Revadi G, Sharma JP, Pakhare A, Singhai A, Joshi R, 。入院时,微循环异常是脓毒症及脓毒症相关死亡率的独立预测因素:一项基于医院的研究。《印度重症医学杂志》2022年;26(3):294 - 301。