Short-term effects of passive mobilization on the sublingual microcirculation and on the systemic circulation in patients with septic shock

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dc.citation.volume7
dc.contributor.authorPinheiro, Tuanny Teixeira [UNIFESP]
dc.contributor.authorRezende de Freitas, Flavio Geraldo [UNIFESP]
dc.contributor.authorFiorese Coimbra, Karla Tuanny [UNIFESP]
dc.contributor.authorFerreira Mendez, Vanessa Marques [UNIFESP]
dc.contributor.authorRossetti, Heloisa Baccaro [UNIFESP]
dc.contributor.authorTalma, Paulo Vinicius [UNIFESP]
dc.contributor.authorBafi, Antonio Tonete [UNIFESP]
dc.contributor.authorMachado, Flavia Ribeiro [UNIFESP]
dc.coverageHeidelberg
dc.date.accessioned2020-08-04T13:40:12Z
dc.date.available2020-08-04T13:40:12Z
dc.date.issued2017
dc.description.abstractBackground: Active mobilization is not possible in patients under deep sedation and unable to follow commands. In this scenario, passive therapy is an interesting alternative. However, in patients with septic shock, passive mobilization may have risks related to increased oxygen consumption. Our objective was to evaluate the impact of passive mobilization on sublingual microcirculation and systemic hemodynamics in patients with septic shock. Methods: We included patients who were older than 18 years, who presented with septic shock, and who were under sedation and mechanical ventilation. Passive exercise was applied for 20 min with 30 repetitions per minute. Systemic hemodynamic and microcirculatory variables were compared before (T0) and up to 10 min after (T1) passive exercise. p values <0.05 were considered significant. Results: We included 35 patients (median age [IQR 25-75%]: 68 [49.0-78.0] years mean (+/- SD) Simplified Acute Physiologic Score (SAPS) 3 score: 66.7 +/- 12.1 median [IQR 25-75%] Sequential Organ Failure Assessment (SOFA) score: 9 [7.0-12.0]). After passive mobilization, there was a slight but significant increase in proportion of perfused vessels (PPV) (T0 [IQR 25-75%]: 78.2 [70.9-81.9%] T1 [IQR 25-75%]: 80.0 [75.2-85.1] % p = 0.029), without any change in other microcirculatory variables. There was a reduction in heart rate (HR) (T0 (mean +/- SD): 95.6 +/- 22.0 bpm T1 (mean +/- SD): 93.8 +/- 22.0 bpm p < 0.040) and body temperature (T0 (mean +/- SD): 36.9 +/- 1.1 degrees C T1 (mean +/- SD): 36.7 +/- 1.2 degrees C p < 0.002) with no change in other systemic hemodynamic variables. There was no significant correlation between PPV variation and HR (r = -0.010, p = 0.955), cardiac index (r = 0.218, p = 0.215) or mean arterial pressure (r = 0.276, p = 0.109) variation. Conclusions: In patients with septic shock after the initial phase of hemodynamic resuscitation, passive exercise is not associated with relevant changes in sublingual microcirculation or systemic hemodynamics.en
dc.description.affiliationUniv Fed Sao Paulo, Anesthesiol Pain & Intens Care Dept, Napoleao Barros 737, BR-04024002 Sao Paulo, SP, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Anesthesiol Pain & Intens Care Dept, Napoleao Barros 737, BR-04024002 Sao Paulo, SP, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundacao de Apoio a Pesquisa do Estado de Sao Paulo FAPESP
dc.description.sponsorshipIDFAPESP: 2012 19 051-1
dc.identifierhttp://dx.doi.org/10.1186/s13613-017-0318-x
dc.identifier.citationAnnals Of Intensive Care. Heidelberg, v. 7,.2017.
dc.identifier.doi10.1186/s13613-017-0318-x
dc.identifier.fileWOS000410035400001.pdf
dc.identifier.issn2110-5820
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/57370
dc.identifier.wosWOS:000410035400001
dc.language.isoeng
dc.publisherSpringer Heidelberg
dc.relation.ispartofAnnals Of Intensive Care
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectSepsisen
dc.subjectShocken
dc.subjectsepticen
dc.subjectPhysical therapy specialtyen
dc.subjectExercise therapyen
dc.subjectMicrocirculationen
dc.subjectIntensive careen
dc.titleShort-term effects of passive mobilization on the sublingual microcirculation and on the systemic circulation in patients with septic shocken
dc.typeinfo:eu-repo/semantics/article
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