Aim: 

To compare the behaviour of tissue hypoxia-ischemia markers in hepatosplanchnic area and pulmonary artery blood, in early phases of severe sepsis in patients admitted to ICU, when few clinical signs of lack of oxygen supply to one or more organ systems are present..

Method: 

Twelve (12) patients were included, 6 with severe sepsis criteria (S) and a control group (NS) of 6 patients. All patients were admitted at ICU after abdominal surgery.

Two floating balloon tipped catheters were placed in each patient. One in the pulmonary artery (distal lumen in pulmonary artery -PA-), and another in the right femoral vein (distal lumen in suprahepathic vein -SH-).

Between 24 and 48 hours after ICU admission blood samples were obtained simultaneously through the two lines and SO₂, haemoglobin levels, pH, pO₂ and lactate concentration were determined.

Results: 

SO₂ was higher (mean difference of +3.45%) in blood from PA in S group, while this difference changed when blood samples came from SH vein (mean difference –13.47%). Lactate levels from both catheters and PO₂ in samples from PA were higher in septic patients. On the other hand, pH values in blood from both catheters and PO₂ in samples from SH vein were higher in patients from the NS group.

Conclusions: 

It is possible to identify markers of early cellular hypoxic injury in septic patients at early stages of illness. SO₂ in mixed venous blood, and especially in the splanchnic region, are the indicators with the highest discriminative value and the ones that provide more information.