• Journal of critical care · Oct 2019

    Observational Study

    Effects of short-term hyperoxia on sytemic hemodynamics, oxygen transport, and microcirculation: An observational study in patients with septic shock and healthy volunteers.

    • Emilio Daniel Valenzuela Espinoza, Mario Omar Pozo, Kanoore Edul Vanina Siham VS Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Cátedra de Farmacología Aplicada, 60 y 120, 1900 La Plata, Argentina., Mariano Furche, María Fernanda Motta, Risso Vazquez Alejandro A Servicio de Terapia Intensiva, Sanatorio Otamendi, Azcuénaga 870, C1115 AAB Ciudad Autónoma de Buenos Aires, Argentina., Paolo Nahuel Rubatto Birri, and Arnaldo Dubin.
    • Servicio de Terapia Intensiva, Sanatorio Otamendi, Azcuénaga 870, C1115 AAB Ciudad Autónoma de Buenos Aires, Argentina.
    • J Crit Care. 2019 Oct 1; 53: 62-68.

    PurposeTo characterize the microvascular effects of a brief period of hyperoxia, in patients with septic shock and in healthy volunteers.Materials And MethodsIn 20 patients with septic shock, we assessed systemic hemodynamics, sublingual microcirculation by SDF-videomicroscopy, and skin perfusion by capillary refill time (CRT), central-peripheral temperature (ΔT°), and perfusion index. Measurements were performed at baseline and after 5 min of inspired oxygen fraction of 1.00. Additionally, we studied 8 healthy volunteers, in whom hyperoxia was prolonged to 30 min.ResultsIn septic patients, hyperoxia increased mean arterial pressure and systemic vascular resistance, but cardiac output remained unchanged. The only significant change in sublingual microcirculation was a decreased heterogeneity flow index (1.03 [1.01-1.07] vs 1.01 [0.34-1.05], P = .002). Perfused vascular density (13.1 [12.0-15.0] vs 14.0 [12.2-14.8] mm/mm2, P = .21) and the other sublingual microvascular variables were unmodified. CRT and ΔT° did not change but perfusion index slightly decreased. In healthy volunteers, sublingual microcirculation and skin perfusion were stable.ConclusionsShort-term hyperoxia induced systemic cardiovascular changes but was not associated with noticeable derangement in sublingual microcirculation and skin perfusion. Nevertheless, longer exposures to hyperoxia might have produced different results.Copyright © 2019 Elsevier Inc. All rights reserved.

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