Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study.

Background Conduit arteries, especially the aorta, play a major role in ensuring efficient cardiac function and optimal microvascular flow due to their viscoelastic properties. Studies in animals and on isolated arteries show that acute systemic inflammation can cause aortic stiffening which affects hemodynamic efficiency. Carotid-femoral pulse wave velocity, a measure of aortic stiffness, may be useful as a bedside investigational method in patients with early sepsis admitted to intensive care, as circulatory changes can lead to multiple organ failure and increased mortality. This study aims to investigate arterial stiffness in early sepsis and its association with clinical outcomes. Metho…

Impact of increased mean arterial pressure on skin microcirculatory oxygenation in vasopressor-requiring septic patients: an interventional study

Abstract Background Heterogeneity of microvascular blood flow leading to tissue hypoxia is a common finding in patients with septic shock. It may be related to suboptimal systemic perfusion pressure and lead to organ failure. Mapping of skin microcirculatory oxygen saturation and relative hemoglobin concentration using hyperspectral imaging allows to identify heterogeneity of perfusion and perform targeted measurement of oxygenation. We hypothesized that increasing mean arterial pressure would result in improved oxygenation in areas of the skin with most microvascular blood pooling. Methods We included adult patients admitted to the intensive care unit within the previous 24 h with sepsis a…

Additional file 1: of Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study

Table S1. Results of Cox regression analysis of the association between pulse wave velocity and length of survival. (DOCX 15 kb)

Microcirculation and mean arterial pressure: friends or foes?—reply

Aortic stiffness in patients with early sepsis

Acute and chronic systemic inflammatory conditions are associated with aortic stiffening. Carotid-femoral pulse wave velocity (PWV), a marker of aortic stiffness, increases in patients with inflammatory diseases and independently correlates to levels of C-reactive protein (CRP). The effects of massive inflammatory response in early sepsis on mechanical properties of the aorta have not been investigated. The objective of the current study was to prospectively assess aortic stiffness in patients with early severe sepsis and septic shock and relate it to inflammatory and haemodynamic variables and outcome.

Prediction of Difficult Tracheal Videolaryngoscopic Intubation Using El-Ganzouri Risk Index

Summary Introduction. Unanticipated difficult intubation still exists as a significant problem. El-Ganzouri risk index is a bedside difficult airway evaluation method, which can help determine risk of difficult airways. However, evidence of using of El-Ganzouri risk index in difficult laryngeal visualisation using videolaryngoscopes is limited. Aim of the Study. Determine the specificity and sensitivity of El-Ganzouri multivariate risk index to predict difficult laryngeal exposure using Storz C-MAC videolaryngoscope equipped with D type blade. Material and methods. We conducted a study of 29 patients, which were examined using El-Ganzouri risk index before induction of anaesthesia. After in…

Novel hybrid technology for early diagnostics of sepsis

Sepsis is a potentially fatal disease with mortality rate as high as 50% in patients with septic shock; mortality rate can increase by 7.6% per hour if appropriate treatment is not started. Internationally accepted guidelines for diagnosis of sepsis rely on vital sign monitoring and laboratory tests in order to recognize organ failure. This pilot study aims to explore the potential of hyperspectral and thermal imaging techniques to identify and quantify early alterations in skin oxygenation and perfusion induced by sepsis. The study comprises both physiological model experiments on healthy volunteers in a laboratory environment, as well as screening case series of patients with septic shock…

Additional file 1: of Association between increased arterial stiffness and clinical outcomes in patients with early sepsis: a prospective observational cohort study

Table S1. Results of Cox regression analysis of the association between pulse wave velocity and length of survival. (DOCX 15 kb)