Restoring arterial pressure with norepinephrine improves muscle tissue oxygenation assessed by near-infrared spectroscopy in severely hypotensive septic patients

Abstract

Norepinephrine administration aimed at achieving a MAP higher than 65 mmHg in septic shock patients with life-threatening hypotension resulted in improvement of NIRS variables measured at the level of the thenar eminence.

A high mean arterial pressure target is associated with improved microcirculation in septic shock patients with previous hypertension: A prospective open-label study

“…Georger and colleagues [25] found that NE administration is associated with an increase in MAP and cardiac index, which resulted in improvements of near-infrared spectroscopy variables in septic shock patients. In our study, the NE-induced increase in cardiac output was 1 l/minute on average, which might be another reason for the microcirculatory improvement.…”

Microcirculação na unidade de terapia intensiva

“…Accordingly, Georger et al showed that the increase in mean arterial blood pressure from 54 ± 8 to 77 ± 9 mmHg improves ΔStO 2 . (15) This finding could be interpreted as an improvement in microvascular perfusion in response to the elevation of blood pressure above the lower limit of the autoregulation of blood flow.…”

Multimodal individualized concept of hemodynamic monitoring

“…Red blood cell transfusion improved only the severely impaired microcirculation, whereas preserved microcirculation worsened after transfusion [62]. With the use of vasopressors after reaching adequate perfusion pressure, microcirculation was also restored; however, further increase in mean arterial pressure did not improve microcirculation [63]. Positive inotropic agents improved capillary perfusion with a proportional decrease in lactate level in critically ill patients [64].…”