StO₂ guided early resuscitation in subjects with severe sepsis or septic shock: a pilot randomised trial.
The scientific community has agreed upon developing accurate monitoring of tissue perfusion and oxygenation to improve the management of subjects with sepsis. This pilot study aimed to investigate the feasibility of targeting tissue oxygen saturation (StO₂) in addition to the currently recommended r...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 27; no. 3; pp. 215 - 222 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Springer Nature
Jun2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104073365&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104073365 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Jun2013 vid: 27 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 104073365 104073365 NLM23381608 2012120655 10.1007/s10877-013-9432-y NLM23381608 104073365 ppf: 215 ppct: 7 formats: fmt: @attributes: type: P tig: atl: StO₂ guided early resuscitation in subjects with severe sepsis or septic shock: a pilot randomised trial. aug: au: Nardi, Olivier Polito, Andrea Aboab, Jérôme Colin, Gwenhael Maxime, Virginie Clair, Bernard Friedman, Diane Orlikowski, David Sharshar, Tarek Annane, Djillali affil: General Intensive Care Unit, Raymond Poincaré Hospital (AP-HP), 104 boulevard Raymond Poincaré, 92380, Garches, France, olivier.nardi@yahoo.fr. sug: subj: Oxygen Consumption Sepsis Therapy Shock, Septic Therapy Adult Aged Algorithms Female Human Male Middle Age Monitoring, Physiologic Muscle, Skeletal Metabolism Pilot Studies Resuscitation Methods Sepsis Metabolism Sepsis Mortality Shock, Septic Metabolism Shock, Septic Mortality Spectroscopy, Near-Infrared Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: The scientific community has agreed upon developing accurate monitoring of tissue perfusion and oxygenation to improve the management of subjects with sepsis. This pilot study aimed to investigate the feasibility of targeting tissue oxygen saturation (StO₂) in addition to the currently recommended resuscitation goals, central venous pressure, mean arterial pressure and central venous oxygen saturation, in patients with severe sepsis or septic shock. A pilot, single-centre, randomised, non-blinded trial recruited 30 subjects with severe sepsis upon intensive care unit admission at an academic medical centre in France. Subjects were randomly assigned to a 6 h resuscitation strategy following the Surviving Sepsis Campaign guidelines with (experimental) or without (control) StO₂. StO₂ was measured over several muscles (masseter, deltoid and pectoral or thenar muscles), and a StO₂ above 80 % over at least 2 muscles was the therapeutic goal. The primary outcome was evaluated as follows: 7-day mortality or worsening of SOFA score between day 7 and study onset, i.e., DSOFA > 0). Thirty subjects were included in the study over a period of 40 weeks. Fifteen subjects were included in each group. Monitoring of StO₂ over three areas was performed in the experimental group. However, measures over the pectoral muscle provided poor results. At study day 7, there were 5/15 (33.3 %) subjects who died or had a DSOFA > 0 in the experimental arm and 4/15 (26.6 %) who died or had a DSOFA > 0 in the control arm (p = 1.00). This pilot study was the first randomised controlled trial using an algorithm derived from the SSC recommendations, which included StO₂ as a treatment goal. However, the protocol showed no clear trend for or against targeting StO₂. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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