caa a22 4500 605509883 CHVBK 20210128100643.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s10877-014-9653-8 doi (NATIONALLICENCE)springer-10.1007/s10877-014-9653-8 Tissue perfusion and oxygenation to monitor fluid responsiveness in critically ill, septic patients after initial resuscitation: a prospective observational study [Elektronische Daten] [Eva Klijn, Marit van Velzen, Alexandre Lima, Jan Bakker, Jasper van Bommel, A. Groeneveld] Fluid therapy after initial resuscitation in critically ill, septic patients may lead to harmful overloading and should therefore be guided by indicators of an increase in stroke volume (SV), i.e. fluid responsiveness. Our objective was to investigate whether tissue perfusion and oxygenation are able to monitor fluid responsiveness, even after initial resuscitation. Thirty-five critically ill, septic patients underwent infusion of 250mL of colloids, after initial fluid resuscitation. Prior to and after fluid infusion, SV, cardiac output sublingual microcirculatory perfusion (SDF: sidestream dark field imaging) and skin perfusion and oxygenation (laser Doppler flowmetry and reflectance spectroscopy) were measured. Fluid responsiveness was defined by a ≥5 or 10% increase in SV upon fluids. In responders to fluids, SDF-derived microcirculatory and skin perfusion and oxygenation increased, but only the increase in cardiac output, mean arterial and pulse pressure, microvascular flow index and relative Hb concentration and oxygen saturation were able to monitor a SV increase. Our proof of principle study demonstrates that non-invasively assessed tissue perfusion and oxygenation is not inferior to invasive hemodynamic measurements in monitoring fluid responsiveness. However skin reflectance spectroscopy may be more helpful than sublingual SDF. The Author(s), 2015 Fluid loading nationallicence Microcirculation nationallicence Passive leg raising nationallicence Microvascular oxygenation nationallicence Septic shock nationallicence Klijn Eva Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut van Velzen Marit Departments of Anaesthesiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands aut Lima Alexandre Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut Bakker Jan Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut van Bommel Jasper Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut Groeneveld A. Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut Journal of Clinical Monitoring and Computing Springer Netherlands 29/6(2015-12-01), 707-712 1387-1307 29:6<707 2015 29 10877 https://doi.org/10.1007/s10877-014-9653-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10877-014-9653-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Klijn Eva Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Velzen Marit Departments of Anaesthesiology, Erasmus MC University Medical Centre, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Lima Alexandre Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Bakker Jan Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- van Bommel Jasper Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut NATIONALLICENCE 700 1- Groeneveld A. Departments of Intensive Care, Erasmus MC University Medical Centre, Room H 621, PO box 2040, 3000 CA, Rotterdam, The Netherlands aut NATIONALLICENCE 773 0- Journal of Clinical Monitoring and Computing Springer Netherlands 29/6(2015-12-01), 707-712 1387-1307 29:6<707 2015 29 10877