PURPOSE: Noninvasive evaluation of endothelial function may be accomplished by ultrasound assessment of flow-mediated vasodilation (FMD) of the brachial artery. This study aims to investigate the role of FMD analysis on intrahospital prognosis of patients with sepsis. METHODS: Adult patients admitted to the intensive care unit with severe sepsis or septic shock were consecutively included. Brachial artery FMD was measured upon admission, after 24 and 72 hours. A group of apparently healthy subjects paired for sex and age was used as controls. Patients were followed up to discharge or death. RESULTS: We studied 42 patients (mean age, 51 ± 19 years) with sepsis predominantly of abdominal or respiratory etiology (75%). Acute Physiology And Chronic Health Evaluation II risk score was 23 ± 7, and intrahospital mortality rate was 33%. Flow-mediated vasodilation in septic patients was significantly lower than in healthy controls (1.5 ± 7% vs 6 ± 4%, P < .001). Most of the nonsurvivors (86%) showed a decline in sequential FMD analyses, whereas only 43% of survivors showed a reduction of FMD (P = .01). In nonsurvivors, FMD was significantly lower 72 hours after sepsis onset (-3.3% ± 10% vs 5.2% ± 4%; P < .05; time-group interaction P value = .03). CONCLUSIONS: Brachial FMD is altered in septic patients with hemodynamic instability, and its deterioration may be an early marker of unfavorable prognosis.
PURPOSE: Noninvasive evaluation of endothelial function may be accomplished by ultrasound assessment of flow-mediated vasodilation (FMD) of the brachial artery. This study aims to investigate the role of FMD analysis on intrahospital prognosis of patients with sepsis. METHODS: Adult patients admitted to the intensive care unit with severe sepsis or septic shock were consecutively included. Brachial artery FMD was measured upon admission, after 24 and 72 hours. A group of apparently healthy subjects paired for sex and age was used as controls. Patients were followed up to discharge or death. RESULTS: We studied 42 patients (mean age, 51 ± 19 years) with sepsis predominantly of abdominal or respiratory etiology (75%). Acute Physiology And Chronic Health Evaluation II risk score was 23 ± 7, and intrahospital mortality rate was 33%. Flow-mediated vasodilation in septicpatients was significantly lower than in healthy controls (1.5 ± 7% vs 6 ± 4%, P < .001). Most of the nonsurvivors (86%) showed a decline in sequential FMD analyses, whereas only 43% of survivors showed a reduction of FMD (P = .01). In nonsurvivors, FMD was significantly lower 72 hours after sepsis onset (-3.3% ± 10% vs 5.2% ± 4%; P < .05; time-group interaction P value = .03). CONCLUSIONS: Brachial FMD is altered in septicpatients with hemodynamic instability, and its deterioration may be an early marker of unfavorable prognosis.
Authors: Massimo Venturelli; Gwenael Layec; Joel Trinity; Corey R Hart; Ryan M Broxterman; Russell S Richardson Journal: J Appl Physiol (1985) Date: 2016-11-10
Authors: Andreas Daiber; Sebastian Steven; Alina Weber; Vladimir V Shuvaev; Vladimir R Muzykantov; Ismail Laher; Huige Li; Santiago Lamas; Thomas Münzel Journal: Br J Pharmacol Date: 2016-07-04 Impact factor: 8.739
Authors: Tamas Csipo; Benjamin R Cassidy; Priya Balasubramanian; Douglas A Drevets; Zoltan I Ungvari; Andriy Yabluchanskiy Journal: Front Aging Neurosci Date: 2021-05-14 Impact factor: 5.750
Authors: Simon Bourcier; Jérémie Joffre; Vincent Dubée; Gabriel Preda; Jean-Luc Baudel; Naïke Bigé; Guillaume Leblanc; Bernard I Levy; Bertrand Guidet; Eric Maury; Hafid Ait-Oufella Journal: Crit Care Date: 2017-06-23 Impact factor: 9.097
Authors: Sabrina H van Ierssel; Philippe G Jorens; Emeline M Van Craenenbroeck; Viviane M Conraads Journal: Biomed Res Int Date: 2014-04-01 Impact factor: 3.411