ArticleCritical care (London, England)2009
Sepsis-associated microvascular dysfunction measured by peripheral arterial tonometry: an observational study.
Article in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 59 citations in OpenAlex.
- Effects of Oxygen on Perioperative Vascular Function: A Randomized Clinical Trial.Journal of the American Heart Association · 2025Trial
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- Persistent Subclinical Inflammation and Long-term Functional and Cognitive Outcomes After Dengue Shock and Septic Shock in Vietnam.Open forum infectious diseases · 2025Article
- Ultrasound-measured brachial artery reactive hyperemia in critically ill patients: an observational study.Critical care (London, England) · 2025Observational
- Non-invasive point-of-care optical technique for continuous in vivo assessment of microcirculatory function: Application to a preclinical model of early sepsis.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2024Article
- Peripheral ischemic reserve in sepsis and septic shock as a new bedside prognostic enrichment tool: A Brazilian cohort study.PloS one · 2023Observational
- A new perspective on NO pathway in sepsis and ADMA lowering as a potential therapeutic approach.Critical care (London, England) · 2022Review
- Peripheral arterial tonometry as a method of measuring reactive hyperaemia correlates with organ dysfunction and prognosis in the critically ill patient: a prospective observational study.Journal of clinical monitoring and computing · 2021Observational
- Microvascular dysfunction in septic and dengue shock: Pathophysiology and implications for clinical management.Global cardiology science & practice · 2020Review
- Overview of the Assessment of Endothelial Function in Humans.Frontiers in medicine · 2020Review
- Article
- Impaired vascular reactivity in sepsis - a systematic review with meta-analysis.Archives of medical sciences. Atherosclerotic diseases · 2019Article
- Endothelial Nitric Oxide Pathways in the Pathophysiology of Dengue: A Prospective Observational Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Observational
- Marked regional endothelial dysfunction in mottled skin area in patients with severe infections.Critical care (London, England) · 2017Observational
- Pharmacokinetic-Pharmacodynamic Model for the Effect of l-Arginine on Endothelial Function in Patients with Moderately Severe Falciparum Malaria.Antimicrobial agents and chemotherapy · 2016Observational
- Endothelial dysfunction is a potential contributor to multiple organ failure and mortality in aged mice subjected to septic shock: preclinical studies in a murine model of cecal ligation and puncture.Critical care (London, England) · 2014Article
- Predicting outcome from dengue.BMC medicine · 2014Review
- Dengue therapeutics, chemoprophylaxis, and allied tools: state of the art and future directions.PLoS neglected tropical diseases · 2014Review
- Neutrophils with myeloid derived suppressor function deplete arginine and constrain T cell function in septic shock patients.Critical care (London, England) · 2014Article
- Increased plasma arginase activity in human sepsis: association with increased circulating neutrophils.Clinical chemistry and laboratory medicine · 2014Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSepsis has a high mortality despite advances in management. Microcirculatory and endothelial dysfunction contribute to organ failure, and better tools are needed to assess microcirculatory responses to adjunctive therapies. We hypothesised that peripheral arterial tonometry (PAT), a novel user-independent measure of endothelium-dependent microvascular reactivity, would be impaired in proportion to sepsis severity and related to endothelial activation and plasma arginine concentrations.
methodsObservational cohort study in a 350-bed teaching hospital in tropical Australia. Bedside microvascular reactivity was measured in 85 adults with sepsis and 45 controls at baseline and 2-4 days later by peripheral arterial tonometry. Microvascular reactivity was related to measures of disease severity, plasma concentrations of L-arginine (the substrate for nitric oxide synthase), and biomarkers of endothelial activation.
resultsBaseline reactive hyperaemia index (RH-PAT index), measuring endothelium-dependent microvascular reactivity; (mean [95% CI]) was lowest in severe sepsis (1.57 [1.43-1.70]), intermediate in sepsis without organ failure (1.85 [1.67-2.03]) and highest in controls (2.05 [1.91-2.19]); P < 0.00001. Independent predictors of baseline RH-PAT index in sepsis were APACHE II score and mean arterial pressure, but not plasma L-arginine or markers of endothelial activation. Low baseline RH-PAT index was significantly correlated with an increase in SOFA score over the first 2-4 days (r = -0.37, P = 0.02).
conclusionsEndothelium-dependent microvascular reactivity is impaired in proportion to sepsis severity and suggests decreased endothelial nitric oxide bioavailability in sepsis. Peripheral arterial tonometry may have a role as a user-independent method of monitoring responses to novel adjunctive therapies targeting endothelial dysfunction in sepsis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.