The prognostic value of muscle regional oxygen saturation index in severe community-acquired pneumonia: a prospective observational study.

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  • dc.contributor.author Claverias, Lauraca
  • dc.contributor.author Marí, Antoni, 1944-ca
  • dc.contributor.author Marin Corral, Judithca
  • dc.contributor.author Magret, Mónicaca
  • dc.contributor.author Trefler, Sandraca
  • dc.contributor.author Bodí, Maríaca
  • dc.contributor.author García-España, Antonioca
  • dc.contributor.author Yébenes, Juan Carlosca
  • dc.contributor.author Pascual, Sergi, 1979-ca
  • dc.contributor.author Gea Guiral, Joaquimca
  • dc.contributor.author Rodríguez, Alejandroca
  • dc.date.accessioned 2016-04-21T11:23:02Z
  • dc.date.available 2016-04-21T11:23:02Z
  • dc.date.issued 2016
  • dc.description.abstract BACKGROUND: Community-acquired pneumonia (CAP) mortality exceeds 20 % in critical care patients despite appropriate antibiotic therapy. Regional tissue oxygen saturation index (rSO2) measured with near-infrared spectroscopy (NIRS) might facilitate early detection for patients at risk of serious complications. Our objectives were to determine the relationship between early determination of rSO2 and mortality and to compare discrimination power for mortality of rSO2 and other resuscitation variables in critically ill CAP patients. METHODS: This is a prospective observational study. Patients with CAP were enrolled within 6 h to intensive care admission. Demographics and clinical variables were recorded. rSO2 was determined using NIRS in brachioradialis muscle. All variables were determined at baseline and 24 h after admission. RESULTS: Forty patients were enrolled. Fourteen patients (35 %) had a baseline rSO2 < 60 % and 7 of them died (50 %). Only 1 of 26 (3.8 %) patients with rSO2 ≥ 60 % died (p = 0.007). The area under ROC curve (AUROC) showed consistent mortality discrimination at baseline (0.84, p = 0.03) and at 24 h (0.86, p = 0.006) for rSO2 values. Cox regression analysis showed that "low" rSO2 at ICU admission (hazard ratio (HR) = 8.99; 95 % confidence interval (CI) 1.05-76.8; p = 0.045) and "low" rSO2 at 24 h (HR = 13.18; 95 % CI 1.52-113.6; p = 0.019) were variables independently associated with mortality. In contrast, other variables such as Acute Physiology and Chronic Health Evaluation (APACHE II) score (HR = 1.09; 95 % CI 0.99-1.19; p = 0.052) were not associated with mortality. CONCLUSIONS: Our findings suggest that forearm skeletal muscle rSO2 differs in patients with severe CAP according to outcome and might be an early prognosis tool.ca
  • dc.description.sponsorship This study was partially supported by grants from the Fondo de Investigación Sanitaria (FIS PI10/01538, PI13/02011) and SGR2013/0926
  • dc.format.mimetype application/pdfca
  • dc.identifier.citation Claverias L, Marí M, Marín-Corral J, Magret M, Trefler S, Bodí M et al. The prognostic value of muscle regional oxygen saturation index in severe community-acquired pneumonia: a prospective observational study. J Intensive Care. 2016 Jan 19;4:7. DOI: 10.1186/s40560-016-0129-4ca
  • dc.identifier.doi http://dx.doi.org/10.1186/s40560-016-0129-4
  • dc.identifier.issn 2052-0492
  • dc.identifier.uri http://hdl.handle.net/10230/26151
  • dc.language.iso engca
  • dc.publisher BioMed Centralca
  • dc.relation.ispartof Journal of Intensive Care. 2016 Jan 19;4:7
  • dc.rights © 2016 Claverias et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.ca
  • dc.rights.accessRights info:eu-repo/semantics/openAccessca
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/ca
  • dc.subject.other Pneumòniaca
  • dc.subject.other Septicèmiaca
  • dc.title The prognostic value of muscle regional oxygen saturation index in severe community-acquired pneumonia: a prospective observational study.ca
  • dc.type info:eu-repo/semantics/articleca
  • dc.type.version info:eu-repo/semantics/publishedVersionca

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Articles (Hospital del Mar Research Institute)
Articles (Departament de Medicina i Ciències de la Vida)