OBJECTIVES: Diabetes mellitus is accompanied by microvascular complications leading to organ dysfunction, while sepsis is a major cause of morbidity and mortality in diabetics. We addressed the hypothesis that red blood cell (RBC) deformability may be additively compromised in septic diabetic patients, leading to a further impairment of microcirculation. METHODS: Forty patients suffering from severe sepsis, 12 patients suffering from diabetes and 24 diabetic patients with severe sepsis were enrolled. A filtration method and a hemorheometer were used to measure the RBCs' index of rigidity (IR). RESULTS: We observed no differences in severity, organ dysfunction and outcome between diabetic and non-diabetic septic patients. Mean SAPS II score was 23.5% vs 26.8% in non-diabetic and diabetic septic patients, respectively. The mortality in non-diabetic septic patients was 22.5% and in septic diabetics was 34.3%, while septic shock occurred in 15.0% and 20.8%, respectively. We detected higher IR (17.72+/-6.31) in septic diabetics than in patients with diabetes and no sepsis (12.26+/-2.28, p< or =0.001) and in patients with sepsis and no diabetes (13.9+/-2.86, p< or =0.01). CONCLUSION: The presence of diabetes mellitus seems to affect the already compromised RBC deformability of septic patients, probably leading to serious microcirculatory functional impairments in septic diabetic patients.
OBJECTIVES:Diabetes mellitus is accompanied by microvascular complications leading to organ dysfunction, while sepsis is a major cause of morbidity and mortality in diabetics. We addressed the hypothesis that red blood cell (RBC) deformability may be additively compromised in septic diabeticpatients, leading to a further impairment of microcirculation. METHODS: Forty patients suffering from severe sepsis, 12 patients suffering from diabetes and 24 diabeticpatients with severe sepsis were enrolled. A filtration method and a hemorheometer were used to measure the RBCs' index of rigidity (IR). RESULTS: We observed no differences in severity, organ dysfunction and outcome between diabetic and non-diabetic septicpatients. Mean SAPS II score was 23.5% vs 26.8% in non-diabetic and diabetic septicpatients, respectively. The mortality in non-diabetic septicpatients was 22.5% and in septic diabetics was 34.3%, while septic shock occurred in 15.0% and 20.8%, respectively. We detected higher IR (17.72+/-6.31) in septic diabetics than in patients with diabetes and no sepsis (12.26+/-2.28, p< or =0.001) and in patients with sepsis and no diabetes (13.9+/-2.86, p< or =0.01). CONCLUSION: The presence of diabetes mellitus seems to affect the already compromised RBC deformability of septicpatients, probably leading to serious microcirculatory functional impairments in septic diabeticpatients.
Authors: Jose M Sosa; Nathan D Nielsen; Seth M Vignes; Tanya G Chen; Sergey S Shevkoplyas Journal: Clin Hemorheol Microcirc Date: 2014 Impact factor: 2.375
Authors: Judith C A Cluitmans; Venkatachalam Chokkalingam; Arno M Janssen; Roland Brock; Wilhelm T S Huck; Giel J C G M Bosman Journal: Biomed Res Int Date: 2014-09-10 Impact factor: 3.411
Authors: Paula R Knox de Souza; Sabrina S Ferreira; Fernanda P B Nunes; Felipe B Casagrande; Fernando H G Tessaro; Mariana C F Silva; José Walber Miranda Costa Cruz; Elsa M Mamizuka; Joilson O Martins Journal: Front Immunol Date: 2019-01-17 Impact factor: 7.561