Evidence map›Paper›PMID 37712807›Full record

Observational studyCritical care science

Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study.

Ana Carolina de Miranda, Fernanda do Carmo De Stefani, Bruna Cassia Dal Vesco, Hipólito Carraro Júnior, Jamil Assreuy, Luis Gustavo Morello, Igor Alexandre Cortês de Menezes

Abstract readObservational Study
In one paragraph

Observational study in Critical care science. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Ana Carolina de MirandaDepartment of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná - Curitiba (PR), Brazil.ORCID http://orcid.org/0000-0002-2075-1771
Fernanda do Carmo De StefaniIntensive Care Unit, Hospital de Clínicas, Universidade Federal do Paraná - Curitiba (PR), Brazil.ORCID http://orcid.org/0000-0003-1756-5844
Bruna Cassia Dal VescoIntensive Care Unit, Hospital de Clínicas, Universidade Federal do Paraná - Curitiba (PR), Brazil.ORCID http://orcid.org/0000-0001-8642-6376
Hipólito Carraro JúniorIntensive Care Unit, Hospital de Clínicas, Universidade Federal do Paraná - Curitiba (PR), Brazil.ORCID http://orcid.org/0000-0003-1765-7570
Jamil AssreuyDepartment of Pharmacology, Universidade Federal de Santa Catarina - Florianópolis (SC), Brazil.ORCID http://orcid.org/0000-0001-8582-1569
Luis Gustavo MorelloInstituto Carlos Chagas, Fundação Oswaldo Cruz - Curitiba (PR), Brazil.ORCID http://orcid.org/0000-0001-6438-8284
Igor Alexandre Cortês de MenezesDepartment of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná - Curitiba (PR), Brazil.ORCID http://orcid.org/0000-0001-9270-0079

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo measure the prognostic value of peripheral ischemic microvascular reserve in the context of persistent sepsis-induced hyperlactatemia and measure its influence on the temporal dynamics of lactate and the strength of association between these variables.

methodsThis post hoc analysis of the peripheral perfusion index/postocclusive reactive hyperemia trial, an observational cohort study that enrolled patients with sepsis who persisted with lactate levels ≥ 2mmol/L after fluid resuscitation (with or without shock). Peripheral ischemic microvascular reserve was evaluated using the association of the peripheral perfusion index and postocclusive reactive hyperemia techniques. The cutoff point of ∆ peripheral perfusion index peak values (%) defined the groups with low (≤ 62%) and high peripheral ischemic microvascular reserve (> 62%).

resultsA total of 108 consecutive patients with persistent sepsis-induced hyperlactatemia were studied. The high peripheral ischemic microvascular reserve group showed higher 28-day mortality than the low peripheral ischemic microvascular reserve group (p < 0.01). The temporal dynamics of lactate within the first 48 hours showed a rapid decrease in lactate levels in the low peripheral ischemic microvascular reserve group (p < 0.01). However, this result was not reproduced in the linear mixed effects model. A weak correlation between peripheral ischemic microvascular reserve (%) and lactate level (mmol/L) was observed within the first 24 hours (r = 0.23; p < 0.05).

conclusionThe prognostic value of high peripheral ischemic microvascular reserve was confirmed in the context of persistent sepsis-induced hyperlactatemia. Although there was a weak positive correlation between peripheral ischemic microvascular reserve value and lactate level within the first 24 hours of sepsis diagnosis, the low peripheral ischemic microvascular reserve group appeared to have a faster decrease in lactate over the 48 hours of follow-up.

Indexed as

HyperemiaHyperlactatemiaSepsisShockHumansLactic AcidLactic Acid

Identifiers

PMID37712807
PMCPMC10406409

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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.