ABSTRACT
Objective:
To evaluate the mechanisms attributed to the prognostic value of peripheral ischemic microvascular reserve in patients with sepsis.
Methods:
This observational cohort study enrolled 46 consecutive septic patients in the intensive care unit between November 2020 and October 2021. After fluid resuscitation, the peripheral ischemic microvascular reserve was evaluated using the association of postocclusion reactive hyperemia with the peripheral perfusion index. Additionally, peripheral venous blood samples were used to evaluate the neuropeptide calcitonin gene-related peptide and substance P levels in the upper limb before and immediately after postocclusion reactive hyperemia
Results:
There was no statistically significant correlation (p > 0.05) between basal values (pg/mL) or variations from neuropeptide levels (%) and the peripheral ischemic microvascular reserve (%).
Conclusion:
Although calcitonin gene-related peptide and substance P may have a prognostic role in sepsis, these neuropeptides do not appear to contribute to peripheral ischemic microvascular reserve.
Keywords:
Sepsis; Microcirculation; Ischemia; Hyperemia; Perfusion index; Neuropeptides
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Sixty-one patients were considered eligible for the study. Fifteen patients were excluded. Forty-six patients were included after proper fluid resuscitation and had subsequent peripheral ischemic microvascular reserve evaluation associated with the analyses of pre- and postischemic substance P and calcitonin gene-related peptide levels. CGRP - calcitonin gene-related peptide.
SP - substance P; CGRP - calcitonin gene-related peptide; PORH - postocclusive reactive hyperemia test.
SP - substance P; CGRP - calcitonin gene-related peptide; PPI - peripheral perfusion index.
SP - substance P; CGRP - calcitonin gene-related peptide; PPI - peripheral perfusion index.