UNASSIGNED:严重脓毒症患者组织水肿影响组织灌注并干扰组织氧合监测。然而,潜在机制尚不清楚.我们使用了无线近红外光谱(NIRS)设备,该设备可传输三波长光以量化组织血红蛋白(Hb)和水(H2O)的含量。我们估计严重脓毒症患者和健康对照的组织H2O,比较它们的差异,并研究了组织H2O与全身血流动力学的相关性及其对组织氧合的影响。
UNASSIGNED:纳入77例新发严重脓毒症患者在72小时内入住重症监护病房,30例健康志愿者(对照)。将NIRS装置放置在参与者的腿上,以估计oxy-Hb([HbO2])的相对组织浓度,脱氧-Hb([HbR]),总Hb([HbT]),和H2O([H2O])在休息连续三天。双样本t检验或曼-惠特尼U检验,卡方检验,并使用广义估计方程(GEE)进行比较。
未经证实:在严重脓毒症患者中,胫骨前部的[H2O]较高[平均值(标准偏差,95%置信区间),10.57(3.37,9.81-11.34)vs.7.40(1.89,6.70-8.11)]和[HbO2],[HBT],和组织Hb氧饱和度(StO2)较低[0.20(0.01,0.20-0.20)vs.0.22(0.01,0.22-0.23),0.42(0.02,0.42-0.43)与0.44(0.02,0.44-0.45),和47.25%(1.97%,46.80-47.70%)与49.88%(1.26%,49.41-50.35%),分别]在第一天测量中高于健康对照组。GEE分析显示[H2O]存在显著差异,[HbO2],[HBT],两组之间连续三天的StO2(均P≤0.001)。此外,[HbO2]和StO2水平在患者组中随时间逐渐降低。[H2O]与[HbO2]和StO2之间呈负相关,随着时间的推移变得更加明显(第1天:r=-0.51和r=-0.42;两者P<0.01;第3天:r=-0.67和r=-0.63,分别两者P<0.01)。第1天收缩压与[H2O]呈正相关(r=0.51,P<0.05),但与组织氧合参数无关。
UNASSIGNED:NIRS可用于定量组织H2O。严重脓毒症患者组织H2O增加,对动脉血压的变化有反应并影响组织氧合。
UNASSIGNED: Tissue oedema affects tissue perfusion and interferes with the monitoring of tissue oxygenation in patients with severe sepsis. However, the underlying mechanisms remain unclear. We used a wireless near-infrared spectroscopy (NIRS) device that transmits tri-wavelength light to quantify tissue haemoglobin (Hb) and water (H2O) content. We estimated tissue H2O in severe sepsis patients and healthy controls, compared their difference, and investigated the correlation of tissue H2O with systemic haemodynamics and its impact on tissue oxygenation.
UNASSIGNED: Seventy-seven adult patients with new-onset severe sepsis admitted to the intensive care unit within 72 h and 30 healthy volunteers (controls) were enrolled. The NIRS device was placed on the participant\'s leg to estimate the relative tissue concentrations of oxy-Hb ([HbO2]), deoxy-Hb ([HbR]), total Hb ([HbT]), and H2O ([H2O]) at rest for three consecutive days. Two-sample t-test or Mann-Whitney U test, chi-square test, and generalised estimating equations (GEEs) were used for comparisons.
UNASSIGNED: In severe sepsis patients, the [H2O] in the anterior tibia was higher [mean (standard deviation, 95% confidence interval), 10.57 (3.37, 9.81-11.34) vs. 7.40 (1.89, 6.70-8.11)] and the [HbO2], [HbT], and tissue Hb oxygen saturation (StO2) were lower [0.20 (0.01, 0.20-0.20) vs. 0.22 (0.01, 0.22-0.23), 0.42 (0.02, 0.42-0.43) vs. 0.44 (0.02, 0.44-0.45), and 47.25% (1.97%, 46.80-47.70%) vs. 49.88% (1.26%, 49.41-50.35%), respectively] than in healthy controls in first-day measurements. GEE analysis revealed significant differences in [H2O], [HbO2], [HbT], and StO2 between groups over three consecutive days (all P≤0.001). In addition, [HbO2] and StO2 levels gradually decreased over time in the patient group. A negative correlation was observed between [H2O] and [HbO2] and StO2, which became more obvious over time (day 1: r=-0.51 and r=-0.42, respectively; both P<0.01; day 3: r=-0.67 and r=-0.63, respectively, both P<0.01). Systolic arterial pressure was positively related to [H2O] (r=0.51, P<0.05, on day 1) but was not associated with tissue oxygenation parameters.
UNASSIGNED: NIRS can be used to quantify tissue H2O. Severe sepsis patients have increased tissue H2O, which responds to changes in arterial blood pressure and affects tissue oxygenation.