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Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock

PURPOSE: The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis. METHODS: We enrolled 51 adult patients in the emergency department (ED) who presented with possible se...

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Autores principales: Schenkman, Kenneth A., Carlbom, David J., Bulger, Eileen M., Ciesielski, Wayne A., Fisk, Dana M., Sheehan, Kellie L., Asplund, Karin M., Shaver, Jeremy M., Arakaki, Lorilee S. L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542555/
https://www.ncbi.nlm.nih.gov/pubmed/28771567
http://dx.doi.org/10.1371/journal.pone.0182351
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author Schenkman, Kenneth A.
Carlbom, David J.
Bulger, Eileen M.
Ciesielski, Wayne A.
Fisk, Dana M.
Sheehan, Kellie L.
Asplund, Karin M.
Shaver, Jeremy M.
Arakaki, Lorilee S. L.
author_facet Schenkman, Kenneth A.
Carlbom, David J.
Bulger, Eileen M.
Ciesielski, Wayne A.
Fisk, Dana M.
Sheehan, Kellie L.
Asplund, Karin M.
Shaver, Jeremy M.
Arakaki, Lorilee S. L.
author_sort Schenkman, Kenneth A.
collection PubMed
description PURPOSE: The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis. METHODS: We enrolled 51 adult patients in the emergency department (ED) who presented with possible sepsis using traditional Systematic Inflammatory Response Syndrome criteria or who triggered a “Code Sepsis.” Noninvasive MOx measurements were made from the first dorsal interosseous muscles of the hand once potential sepsis/septic shock was identified, as soon as possible after admission to the ED. Shock severity was defined by concurrent systolic blood pressure, heart rate, and serum lactate levels. MOx was also measured in a control group of 17 healthy adults. RESULTS: Mean (± SD) MOx in the healthy control group was 91.0 ± 5.5% (n = 17). Patients with mild, moderate, and severe shock had mean MOx values of 79.4 ± 21.2%, 48.6 ± 28.6%, and 42.2 ± 4.7%, respectively. Mean MOx for the mild and moderate shock severity categories were statistically different from healthy controls and from each other based on two-sample t-tests (p < 0.05). CONCLUSIONS: We demonstrate that noninvasive measurement of MOx was associated with clinical assessment of shock severity in suspected severe sepsis or septic shock. The ability of MOx to detect even mild septic shock has meaningful implications for emergency care, where decisions about triage and therapy must be made quickly and accurately. Future longitudinal studies may validate these findings and the value of MOx in monitoring patient status as treatment is administered.
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spelling pubmed-55425552017-08-12 Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock Schenkman, Kenneth A. Carlbom, David J. Bulger, Eileen M. Ciesielski, Wayne A. Fisk, Dana M. Sheehan, Kellie L. Asplund, Karin M. Shaver, Jeremy M. Arakaki, Lorilee S. L. PLoS One Research Article PURPOSE: The aim of this pilot study was to evaluate the potential of a new noninvasive optical measurement of muscle oxygenation (MOx) to identify shock severity in patients with suspected sepsis. METHODS: We enrolled 51 adult patients in the emergency department (ED) who presented with possible sepsis using traditional Systematic Inflammatory Response Syndrome criteria or who triggered a “Code Sepsis.” Noninvasive MOx measurements were made from the first dorsal interosseous muscles of the hand once potential sepsis/septic shock was identified, as soon as possible after admission to the ED. Shock severity was defined by concurrent systolic blood pressure, heart rate, and serum lactate levels. MOx was also measured in a control group of 17 healthy adults. RESULTS: Mean (± SD) MOx in the healthy control group was 91.0 ± 5.5% (n = 17). Patients with mild, moderate, and severe shock had mean MOx values of 79.4 ± 21.2%, 48.6 ± 28.6%, and 42.2 ± 4.7%, respectively. Mean MOx for the mild and moderate shock severity categories were statistically different from healthy controls and from each other based on two-sample t-tests (p < 0.05). CONCLUSIONS: We demonstrate that noninvasive measurement of MOx was associated with clinical assessment of shock severity in suspected severe sepsis or septic shock. The ability of MOx to detect even mild septic shock has meaningful implications for emergency care, where decisions about triage and therapy must be made quickly and accurately. Future longitudinal studies may validate these findings and the value of MOx in monitoring patient status as treatment is administered. Public Library of Science 2017-08-03 /pmc/articles/PMC5542555/ /pubmed/28771567 http://dx.doi.org/10.1371/journal.pone.0182351 Text en © 2017 Schenkman et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schenkman, Kenneth A.
Carlbom, David J.
Bulger, Eileen M.
Ciesielski, Wayne A.
Fisk, Dana M.
Sheehan, Kellie L.
Asplund, Karin M.
Shaver, Jeremy M.
Arakaki, Lorilee S. L.
Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock
title Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock
title_full Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock
title_fullStr Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock
title_full_unstemmed Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock
title_short Muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock
title_sort muscle oxygenation as an indicator of shock severity in patients with suspected severe sepsis or septic shock
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542555/
https://www.ncbi.nlm.nih.gov/pubmed/28771567
http://dx.doi.org/10.1371/journal.pone.0182351
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