atterns of vascular response immediately after passive mobilization in patients with sepsis: an observational transversal stud

Author(s)

Kawakami, Debora Mayumi de Oliveira ^[1] ; Bonjorno-Junior, Jose Carlos ^[2] ; da Silva Destro, Tamara Rodrigues ^[3] ; Biazon, Thais Marina Pires de Campos ^[1] ; Garcia, Naiara Molina ^[4] ; Bonjorno, Flavia Cristina Rossi Caruso ^[1] ; Borghi-Silva, Audrey ^[1] ; Mendes, Renata Goncalves ^{[1, 5]}

Affiliation

^[1] Fed Univ Sao Carlos UFSCar, Dept Phys Therapy, Sao Carlos, SP - Brazil

^[2] Fed Univ Sao Carlos UFSCar, Dept Med, Sao Carlos - Brazil

^[3] Fratern Santa Casa Misericordia Hosp Sao Carlos, Intens Care Unit, Sao Carlos, SP - Brazil

^[4] Fed Univ Sao Carlos UFSCar, Univ Hosp, Sao Carlos, SP - Brazil

^[5] Fed Univ Sao, Dept Phys Therapy, Carlos Rod Washington Luis Km 235, BR-13565905 Sao Carlos, SP - Brazil

• Document type: Journal article
• Source: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING; v. 38, n. 2 SEP 2021.
• Web of Science Citations: 0

Abstract

Sepsis is a serious organ dysfunction leading to endothelial damage in critical patients. Physiologically, there is an augment of vascular diameter in response to increased vascular blood flow and shear stress stimulus. However, the pattern of vascular response in face of passive mobilization (PM), an early mobilization physical strategy, has not yet been explored in patients with sepsis. To explore patterns of vascular response to PM and associations with clinical and cardiovascular profile in patients with sepsis. Cross-sectional, single-arm study. Thirty-two patients diagnosed with sepsis were enrolled. Vascular response was assessed by flow-mediated dilation (FMD) using brachial artery ultrasound, before and after PM. The PM (to assess the response pattern) and SR (shear rate) were also calculated. PM protocol consisted of knees, hips, wrists, elbows, shoulders, dorsiflexion/plantar flexion movements 3 x 10 repetitions each (15 min). Arterial stiffness was assessed by Sphygmocor (R), by analyzing the morphology and pulse wave velocity. Cardiac autonomic modulation (CAM) was assessed by analyzing heart rate variability indexes (mean HR, RMSSD, LF, HF, ApEn, SampEn, DFA). Different vascular responses were observed after PM: (1) increased vascular diameter (responders) (n = 13, %FMD = 11.89 +/- 5.64) and (2) reduced vascular diameter (non-responders) (n = 19, %FMD= -7.42 +/- 6.44). Responders presented a higher non-linear DFA2 index (p = 0.02). There was a positive association between FMD and DFA (r = 0.529; p = 0.03); FMD and SampEn (r = 0.633; p < 0.01). A negative association was identified between FMD and LF (Hz) (r= -0.680; p < 0.01) and IL-6 (r= -0.469; p = 0.037) and SR and CRP (r= -0.427; p = 0.03). (AU)

• FAPESP's process: 15/26501-1 - Study of limiting factors to physical exercise and adjunct effects to rehabilitation on cardiorespiratory disease: a multicentre approach
• Grantee: Audrey Borghi Silva
• Support Opportunities: Research Projects - Thematic Grants