Article Text

other Versions

PDF
The relationship between hyperlactatemia and microcirculation in the thenar eminence as measured using near-infrared spectroscopy in patients with sepsis
  1. Taketomo Soga1,
  2. Kaoru Sakatani2,3,
  3. Tsukasa Yagi1,
  4. Tsuyoshi Kawamorita1,
  5. Atsuo Yoshino3
  1. 1Department of Emergency and Critical Care Medicine, Surugadai Nihon University Hospital, Tokyo, Japan
  2. 2Department of Electrical and Electronics Engineering, Nihon University College of Engineering, Koriyama, Japan
  3. 3Department of Neurological Surgery, Nihon School of Medicine, Tokyo, Japan
  1. Correspondence to Dr Taketomo Soga, Department of Emergency and Critical Care Medicine, Surugadai Nihon University Hospital, 1-8-13, Kanda Surugadai, Chiyoda-ku, Tokyo 101-8309, Japan; taketomo1122{at}r4.dion.ne.jp

Abstract

Objective Near-infrared spectroscopy (NIRS)-derived variables during a vascular occlusion test (VOT) have recently been used to evaluate peripheral circulatory insufficiency in patients with sepsis. We investigated the relationship between NIRS-derived variables and the lactate concentration during sepsis.

Methods This was a prospective observational study. Forty-one patients with sepsis were divided into two groups according to their blood lactate concentration: a high lactate group (≥2.0 mmol/l; n=15) and a normal lactate group (<2.0 mmol/l; n=26). NIRS was used to evaluate the tissue oxygen index (TOI) at the thenar eminence before and after a VOT. VOT was performed by sphygmomanometer cuff inflation around upper arm for 3 min. The TOI value before VOT was defined as the TOI baseline, the TOI value immediately after VOT was defined as the minimum TOI and the TOI value after releasing the muscle from the VOT was defined as the TOI after VOT. The ΔTOI was defined as the difference between the TOI after VOT and minimum TOI.

Results NIRS-derived variables had significant differences between the normal lactate group and the high lactate group with respect to the TOI baseline (median: 65% vs 55%, p=0.01), TOI after VOT (median: 65% vs 46%, p<0.001) and ΔTOI (median: 19% vs 6%, p<0.001). The lactate concentration was significantly correlated with the TOI after VOT (R=0.594, p<0.001), TOI baseline (R=0.513, p<0.001), ΔTOI (R=0.488, p=0.001) and minimum TOI (R=0.377, p=0.02).

Conclusions We revealed a significant correlation between NIRS-derived variables and the lactate concentration during sepsis.

  • intensive care

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.