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

Autor(es)

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]}

Afiliação do(s) autor(es)

^[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

• Tipo de documento: Artigo Científico
• Fonte: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING; v. 38, n. 2 SEP 2021.
• Citações Web of Science: 0

Resumo

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)

• Processo FAPESP: 15/26501-1 - Estudo dos fatores limitantes ao exercício físico e efeitos dos recursos adjuntos à reabilitação nas doenças cardiorrespiratórias crônicas: uma abordagem multicêntrica
• Beneficiário: Audrey Borghi Silva
• Modalidade de apoio: Auxílio à Pesquisa - Temático