Possible role of skeletal muscles in the pathogenesis of hyperdynamic septic shock

Ovsiannikov R.Iu.; Kurapeev I.S.; Lebedinskii K.M.

doi:https://doi.org/10.17116/anaesthesiology201902127

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Abstract:

Abstract As it is well known, septic shock is characterized by the so-called hyperdynamic state, i.e. high level of oxygen delivery associated with reduced systemic oxygen consumption. However, there are data confirming adequate oxygen-utilizing abilities of tissues and also certain tissue- and organ-specific changes in oxygen delivery. Thus, in experimental models of septic shock oxygen tension (PtO2) was increased in skeletal muscles while the same value was reduced in the majority of organs and tissues. However, there was more rapid decrease of this value in patients with sepsis compared with healthy volunteers within the model of tourniquet-induced ischemia. These facts suggest that increased PtO2 in muscles is associated with disproportionately high oxygen delivery to skeletal muscles rather its low consumption. In contrast to the muscles, tissue dysoxia of other organs in septic shock is primarily associated with reduced oxygen delivery. Therefore, instead of the «intra-tissue steal» we can think about the role and tools to restrict «inter-tissue steal» as a possible cause of tissue hypoxia in hyperdynamic septic shock. Restriction of blood flow in skeletal muscles, for example, using pneumatic cuffs, should increase systemic oxygen consumption in patients with hyperdynamic septic shock if our hypothesis is true.

Keywords:

sepsis

septic shock

circulation

oxygen delivery

skeletal muscle

Authors:

Ovsiannikov R.Iu.

Mechnikov North-Western State Medical University of Ministry of Health of the Russia, St. Petersburg, Russia

Kurapeev I.S.

Mechnikov North-Western State Medical University of Ministry of Health of the Russia, St. Petersburg, Russia

Lebedinskii K.M.

FGBOU VO «North-West State Medical University named after I.I. Mechnikov» Ministry of Health of Russia, St. Petersburg, Russia

SPIN RSCI: 3590-2308
Scopus AuthorID: 6602775085
ResearcherID: O-8655-2014
ORCID: 0000-0002-5752-4812

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References:

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