Effects of Sedatives on Sublingual Microcirculation of Patients With Septic Shock
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Previous studies have demonstrated that altered microvascular blood flow is an important marker of severe sepsis. Usually, these patients need invasive ventilatory support, frequent use of sedatives and it is unknown if these agents interfere or not on microvascular blood flow. The goal of this study was to compare effects of propofol and midazolam infusions on sublingual microcirculation of septic shock patients.
Septic patients, after intubation, were initially sedated with propofol. During the second day of mechanical ventilation, propofol infusion was interrupted. When the patient awoke, the sedative drug was changed to midazolam. Sedation target was a Ramsay Scale score of 4 to 5.
Sublingual Microcirculatory Variables [ Time Frame: Just before stopping propofol and thirty minutes after the start of midazolam infusion ]
Patients were sedated with propofol during the first 24 hours after intubation and with midazolam afterwards.Systemic hemodynamics and perfusion parameters were assessed at two time points: just before stopping propofol and thirty minutes after the start of midazolam infusion. At both steps, four microcirculatory sequences were acquired using sidestream darkfield imaging to access sublingual microcirculation
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Ages Eligible for Study:
18 Years and older (Adult, Older Adult)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
Septic shock patients needing mechanical ventilation in pressure or volume-controlled mode.
age less than 18 years,
non-sinus rhythm, and
contraindication of daily interruption of sedative drug,
mainly with the use of neuromuscular blocking drugs, or
patients with intracranial hypertension or epileptical status.