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Baroreflex Sensitivity and Mortality in Septic dysfunction
Author(s) -
Santos Fernando,
Nogueira Antonio Carlos,
Biselli Paolo,
Hoshino Wagner,
Mostarda Cristiano Teixeira,
De Angelis Katia,
Soriano Francisco Garcia,
Irigoyen Maria Claudia
Publication year - 2018
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2018.32.1_supplement.595.5
Subject(s) - baroreflex , septic shock , medicine , organ dysfunction , intensive care unit , sepsis , multiple organ dysfunction syndrome , blood pressure , shock (circulatory) , heart rate , cardiology , gastroenterology
Mortality in experimental septic shock has been attributed to systemic hypotension, hyporeactiveness to vasocostrictors, metabolic acidosis and organ damage but there is no clear information about the involvement of the baroreflex sensitivity (BRS) or autonomic dysfunction in the survival of these animals. In patients with multiple organ dysfunction syndrome autonomic function is impaired and this impairment seems to have prognostic implications. In this study we aimed to observe the role of the baroreflex sensitivity (BRS) in mortality of the patients who were admitted in the intensive care unit from the University of São Paulo Hospital (Univesitary Hospital) with sepsis or septic shock diagnosis (follow up of 28 days). The protocol was approved by Ethics Committee of Hospital and the written informed consent had been obtained from the closest family member. Thirty patients were included in this observational and prospective study in which the patients were analyzed in two groups: survivors and nonsurvivors.. The patients were instrumentalized with direct blood pressure and heart rate recordings, obtained in the first 24 hs in the Instensive Care Unit. The measurements of C reactive protein (Surv: 206.8±25.7, NonS: 204.4±43.6) and gravity APACHE score (Surv: 24.7±0.9, NonS: 24.8±1.0) were similar in the two groups. However, the nonsurvivor group presented reduced glycaemia (NonS: 133.7±10.7 vs Surv: 185.5±16.2 mg/dl) and elevated plasma levels of citokines, IL‐6 (NonS: 1654.1±420.4 vs Surv: 390.1±123.5) and IL‐10 (NonS: 532.3±180.3 vs Surv: 76.0±35.4) and of troponin I (NonS: 1.56±0.4 vs Surv: 0.63±0.2), indicating a myocardial agression. Heart rate variability and the relationship between Heart rate and Blood pressure variation (LF index of BRS) were reduced in septic patients and additionaly reduced in nonsurvivor group. BRS < or =6.5 ms/mmHg were found to be related to mortality in nonsurvivors group by The Kaplan Meyer analysis, suggesting that autonomic dysfunction could be indicative of mortality risk in these patients. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .