Microcirculatory changes caused by magnesium sulphate infusion in severe sepsis and septic shock

A Pranskunas,V Pilvinis

doi:10.1186/cc7412

Abstract

Microcirculatory dysfunction is a key element in the pathogenesis of severe sepsis and septic shock and is related to endothelial dysfunction. Studies in vivo have shown that infusion of magnesium sulphate increased endothelium-dependent vasodilatation in healthy people and patients with cardiac disorders, but the effect on the septic patient's vessels, especially small ones, is unknown. We hypothesized that magnesium sulphate infusion can improve microcirculation in patients with severe sepsis and septic shock.

Highlights

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients
Results of this study show that early tracheostomy, if perioperative complications
The 28-day mortality rate was significantly reduced to 42.4% compared with 56.7% in the control group (P = 0.049, operating room (OR) = 0.56; 95% cardiac index (CI) = 0.32 to 1.00)

Summary

Introduction

There is considerable uncertainty about the reproducibility of the various instruments used to measure dyspnea, their ability to reflect changes in symptoms, whether they accurately reflect the patient’s experience and if its evolution is similar between acute heart failure syndrome patients and nonacute heart failure syndrome patients. Conclusions Our data demonstrate that critically ill patients may be exposed to a higher FiO2 than that required to maintain adequate oxygenation These results highlight an area of ICU care that has received little study, with no published clinical trials examining the effect of FiO2 on outcome. Results Age, sex, the underlying disease and tumour stage (TNM classification), type of previous anticancer treatment, performance status, severity scores (APACHE II, Simplified Acute Physiology Score II, Sequential Organ Failure Assessment), ICU and hospital mortalities and hospital outcome at 3, 6 and 12 months were analysed. Clinical data of 277 post-transplantation patients admitted to the ICU were collected at admission and the SAPS 3 and APACHE II score calculated with respective estimated mortality rates.

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