Evidence mapPaperPMID 22390813Full record

ArticleCritical care (London, England)2012

Brachial artery reactivity in patients with severe sepsis: an observational study.

Orren Wexler, Mary A M Morgan, Michael S Gough, Sherry D Steinmetz, Cynthia M Mack, Denise C Darling, Kathleen P Doolin, Michael J Apostolakos, Brian T Graves, Mark W Frampton and 2 more

Registry-linked trialAbstract read
In one paragraph

Article in Critical care (London, England), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01726595 (Ultrasound Measurement of Reactive Hyperemia in Critical Care), which is not on this map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01726595 completednot on this mapstarted 2013, after this paper: background citation

Ultrasound Measurement of Reactive Hyperemia in Critical Care: Prognostic and Pathophysiologic Significance

TypeobservationalSponsorUniversity of RochesterRan2013 to 2019Enrolled250ConditionsSevere Sepsis, Critical Illness
3 · Its place in the literature

Who cites it

17 citing papers in PubMed.

  1. Trial
  2. Review
  3. Observational
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Observational
  11. Article
  12. Article
  13. Article
  14. Impaired vascular reactivity in sepsis - a systematic review with meta-analysis.Archives of medical sciences. Atherosclerotic diseases · 2019
    Article
  15. Article
  16. Article
  17. Year in review 2012: Critical Care--Cardiology.Critical care (London, England) · 2013
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Orren WexlerDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA.
Mary A M Morgan
Michael S Gough
Sherry D Steinmetz
Cynthia M Mack
Denise C Darling
Kathleen P Doolin
Michael J Apostolakos
Brian T Graves
Mark W Frampton
Xucai Chen
Anthony P Pietropaoli

Funding

Multidisciplinary Training in Pulmonary ResearchT32HL066988 · UNIVERSITY OF ROCHESTER · 2001 to 2005
$2.0M
Estrogen and the Pathophysiology and Outcomes of SepsisK23HL080077 · UNIVERSITY OF ROCHESTER · 2005 to 2005
$151k
NCRR NIH HHS 1 UL1 RR024160-01NCRR NIH HHS UL1 RR024160NHLBI NIH HHS K23 HL080077NHLBI NIH HHS T32 HL066988
6 · The paper itself

Abstract

introductionUltrasound measurements of brachial artery reactivity in response to stagnant ischemia provide estimates of microvascular function and conduit artery endothelial function. We hypothesized that brachial artery reactivity would independently predict severe sepsis and severe sepsis mortality.

methodsThis was a combined case-control and prospective cohort study. We measured brachial artery reactivity in 95 severe sepsis patients admitted to the medical and surgical intensive care units of an academic medical center and in 52 control subjects without acute illness. Measurements were compared in severe sepsis patients versus control subjects and in severe sepsis survivors versus nonsurvivors. Multivariable analyses were also conducted.

resultsHyperemic velocity (centimeters per cardiac cycle) and flow-mediated dilation (percentage) were significantly lower in severe sepsis patients versus control subjects (hyperemic velocity: severe sepsis = 34 (25 to 48) versus controls = 63 (52 to 81), P < 0.001; flow-mediated dilation: severe sepsis = 2.65 (0.81 to 4.79) versus controls = 4.11 (3.06 to 6.78), P < 0.001; values expressed as median (interquartile range)). Hyperemic velocity, but not flow-mediated dilation, was significantly lower in hospital nonsurvivors versus survivors (hyperemic velocity: nonsurvivors = 25 (16 to 28) versus survivors = 39 (30 to 50), P < 0.001; flow-mediated dilation: nonsurvivors = 1.90 (0.68 to 3.41) versus survivors = 2.96 (0.91 to 4.86), P = 0.12). Lower hyperemic velocity was independently associated with hospital mortality in multivariable analysis (odds ratio = 1.11 (95% confidence interval = 1.04 to 1.19) per 1 cm/cardiac cycle decrease in hyperemic velocity; P = 0.003).

conclusionsBrachial artery hyperemic blood velocity is a noninvasive index of microvascular function that independently predicts mortality in severe sepsis. In contrast, brachial artery flow-mediated dilation, reflecting conduit artery endothelial function, was not associated with mortality in our severe sepsis cohort. Brachial artery hyperemic velocity may be a useful measurement to identify patients who could benefit from novel therapies designed to reverse microvascular dysfunction in severe sepsis and to assess the physiologic efficacy of these treatments.

Indexed as

Area Under CurveBlood Flow VelocityBrachial ArteryCase-Control StudiesChi-Square DistributionFemaleHumansIntensive Care UnitsMaleMiddle AgedProspective StudiesReproducibility of ResultsROC CurveSepsisSurvival RateUltrasonography

Identifiers

PMID22390813
PMCPMC3568781

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.