title: Use of reactive hyperemia - peripheral arterial tonometry and circulating biological markers to predict outcomes in sepsis.
abstract: To evaluate the usefulness and prognostic value of reactive hyperemia - peripheral arterial tonometry in patients with sepsis. Moreover, we investigated the association of reactive hyperemia - peripheral arterial tonometry results with serum levels of certain inflammatory molecules.
  Prospective study, conducted in an 18-bed mixed intensive care unit for adults. The exclusion criteria included severe immunosuppression or antibiotic therapy initiated more than 48 hours before assessment. We measured the reactive hyperemia - peripheral arterial tonometry on inclusion (day 1) and on day 3. Interleukin-6, interleukin-10, high-mobility group box 1 protein and soluble ST2 levels were measured in the blood obtained upon inclusion.
  Seventeen of the 79 patients (21.6%) enrolled were determined to have reactive hyperemia - peripheral arterial tonometry signals considered technically unreliable and were excluded from the study. Thus, 62 patients were included in the final analysis, and they underwent a total of 95 reactive hyperemia - peripheral arterial tonometry exams within the first 48 hours after inclusion. The mean age was 51.5 (SD: 18.9), and 49 (62%) of the patients were male. Reactive hyperemia indexes from days 1 and 3 were not associated with vasopressor need, Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation II score, or 28-day mortality. Among the patients who died, compared with survivors, there was a significant increase in the day 3 reactive hyperemia index compared with day 1 (p = 0.045). There was a weak negative correlation between the day 1 reactive hyperemia - peripheral arterial tonometry index and the levels of high-mobility group box 1 protein (r = -0.287).
  Technical difficulties and the lack of clear associations between the exam results and clinical severity or outcomes strongly limits the utility of reactive hyperemia - peripheral arterial tonometry in septic patients admitted to the intensive care unit.
authors.affiliation: Serviço de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.|Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Vandack
authors.initials: V
authors.lastname: Nobre
authors.affiliation: Serviço de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Thiago Bragança
authors.initials: TB
authors.lastname: Ataíde
authors.affiliation: Serviço de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Luisa Caldeira
authors.initials: LC
authors.lastname: Brant
authors.affiliation: Serviço de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Clara Rodrigues
authors.initials: CR
authors.lastname: Oliveira
authors.affiliation: Serviço de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Lucas Vieira
authors.initials: LV
authors.lastname: Rodrigues
authors.affiliation: Programa de Pós-Graduação em Infectologia e Medicina Tropical, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.|Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Antonio Luiz Pinho
authors.initials: AL
authors.lastname: Ribeiro
authors.affiliation: Serviço de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Fernanda Barbosa
authors.initials: FB
authors.lastname: Lopes
authors.affiliation: Serviço de Terapia Intensiva, Hospital das Clínicas, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Ivan Euclides
authors.initials: IE
authors.lastname: Saraiva
authors.affiliation: Programa de Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brasil.
authors.forename: Marcus Vinícius
authors.initials: MV
authors.lastname: Andrade
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000175:diagnosis*; D007362:Intensive Care Units; D008297:Male; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D063305:Organ Dysfunction Scores; D011379:Prognosis; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D013997:Time Factors
chemical_list: D015415:Biomarkers