TY - JOUR
T1 - Association between static and dynamic thenar near-infrared spectroscopy and mortality in patients with sepsis
T2 - A systematic review and meta-analysis
AU - Neto, Ary Serpa
AU - Pereira, Victor Galvão Moura
AU - Manetta, José Antônio
AU - Espósito, Daniel Crepaldi
AU - Schultz, Marcus J.
PY - 2014/1
Y1 - 2014/1
N2 - BACKGROUND: Oxygen delivery and consumption disturbances are frequently seen with critically illness, potentially leading to pathologic changes in tissue oxygenation (StO2). Near-infrared spectroscopy (NIRS) is a potentially useful method to monitor StO2, but the role of NIRS in prognostication of septic patients is uncertain. The aim of this study was to systematically review the literature and evaluate static and dynamic NIRS in patients with sepsis. METHODS: This is a systematic review and meta-analysis of publications between 1966 and 2013. The MEDLINE and EMBASE databases were searched for studies on StO2 in patients with severe sepsis or septic shock. Meta-analysis was limited to studies about static and dynamic variables derived from NIRS in patients with sepsis. The association between StO 2, reperfusion slope (Rres), occlusion slope, and maximum StO 2 minus basal StO2 (δStO2) and prognosis in septic patients was evaluated. RESULTS: The search identified 20 articles (962 participants; 717 with severe sepsis or septic shock, and 245 healthy controls). Compared with healthy controls, septic patients had lower levels of StO2 (78.27% [4.91%] vs. 82.02% [3.57%], p = 0.012), Rres (2.75% [0.63%] vs. 5.19% [2.86%] per second, p = 0.003), and δStO2 (7.86% [0.11%] vs. 12.53% [2.65%], p = 0.011). Survivors from sepsis presents higher levels of StO2 (81.68% [4.68%] vs. 74.54% [5.31%], p = 0.02) and Rres (3.37% [0.44%] vs. 2.16% [0.51%] per second, p = 0.016). CONCLUSION: Septic patients have lower levels of StO2, Rres and δStO 2, and survivors from sepsis present higher levels of StO2 and Rres compared with nonsurvivors.
AB - BACKGROUND: Oxygen delivery and consumption disturbances are frequently seen with critically illness, potentially leading to pathologic changes in tissue oxygenation (StO2). Near-infrared spectroscopy (NIRS) is a potentially useful method to monitor StO2, but the role of NIRS in prognostication of septic patients is uncertain. The aim of this study was to systematically review the literature and evaluate static and dynamic NIRS in patients with sepsis. METHODS: This is a systematic review and meta-analysis of publications between 1966 and 2013. The MEDLINE and EMBASE databases were searched for studies on StO2 in patients with severe sepsis or septic shock. Meta-analysis was limited to studies about static and dynamic variables derived from NIRS in patients with sepsis. The association between StO 2, reperfusion slope (Rres), occlusion slope, and maximum StO 2 minus basal StO2 (δStO2) and prognosis in septic patients was evaluated. RESULTS: The search identified 20 articles (962 participants; 717 with severe sepsis or septic shock, and 245 healthy controls). Compared with healthy controls, septic patients had lower levels of StO2 (78.27% [4.91%] vs. 82.02% [3.57%], p = 0.012), Rres (2.75% [0.63%] vs. 5.19% [2.86%] per second, p = 0.003), and δStO2 (7.86% [0.11%] vs. 12.53% [2.65%], p = 0.011). Survivors from sepsis presents higher levels of StO2 (81.68% [4.68%] vs. 74.54% [5.31%], p = 0.02) and Rres (3.37% [0.44%] vs. 2.16% [0.51%] per second, p = 0.016). CONCLUSION: Septic patients have lower levels of StO2, Rres and δStO 2, and survivors from sepsis present higher levels of StO2 and Rres compared with nonsurvivors.
KW - Microcirculation
KW - Mortality
KW - NIRS
KW - Sepsis
KW - Tissue oxygenation
UR - http://www.scopus.com/inward/record.url?scp=84892145987&partnerID=8YFLogxK
U2 - 10.1097/TA.0b013e3182a9221f
DO - 10.1097/TA.0b013e3182a9221f
M3 - Review Article
C2 - 24368385
AN - SCOPUS:84892145987
VL - 76
SP - 226
EP - 233
JO - The Journal of Trauma and Acute Care Surgery
JF - The Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 1
ER -