The Peak Systolic Velocity Variation of Superior Mesenteric Artery May Predict Gastrointestinal Dysfunction in Septic Patients: A Clinical Observational Research.

Abstract

BackgroundTo investigate the clinical significance of peak systolic velocity (PSV) variation of superior mesenteric artery (SMA) in predicting gastrointestinal dysfunction in septic patients.MethodsA clinical observational study was accomplished in our department. The SMA PSV values on days 1-3 after admission and the PSV variation were measured. The gastrointestinal dysfunction score (GIDS), the numbers of patients with feeding intolerance (FI) symptoms during enteral feeding, and the FI days were recorded. The clinical characteristics, inflammatory biomarkers levels, and disease severity and outcome variables were also collected.ResultsA total of 111 septic patients were enrolled during the study period. The median SMA PSV was 84.4 cm/s on admission. The PSV variation was negatively correlated with GIDS on day 3 (R² = 0.376), GIDS on day 7 (R² = 0.371), and FI days (R² = 0.266) at a moderate strength, whereas was positively correlated with the ICU-free days (R² = 0.116) at a weak strength. Moreover, the PSV variation had a notable value to predict the development of GIDS >2, feeding intolerance, and 28-day mortality. We divided patients into three groups on basis of PSV variation values: -30% < variation ≤ -10% (Group A), -10% < variation ≤ 10% (Group B), and 10% < variation ≤ 30% (Group C). Patients in Group A had increased severity scores, serum levels of procalcitonin, interleukin (IL)-6, IL-10, C-reactive protein, and white blood cell counts compared to those in Group B and C (P < .01). The Group A had increased GIDS, FI incidence, FI days, and 28-day mortality compared to the other two groups (P < .001). The days free of mechanical ventilation and continuous renal replacement therapy in Group A were also lower than those in Group B and C (P < .001).ConclusionThe SMA PSV variation may be correlated with gastrointestinal function in sepsis.