The Effect of Remote Ischemic Conditioning on the Microcirculation in Sepsis

Effects of Remote Ischemic Conditioning on Microcirculatory Alterations in Patients With Sepsis

This study is an evaluation of the effect of Remote ischemic conditioning on sublingual microcirculation in patients with sepsis.

This prospective open-label trial is performed in mixed ICU in a tertiary teaching hospital. Investigators include patients with sepsis or septic shock within the first 24 h after ICU admission. Remote ischemic conditioning (RIC) procedure comprise three repetitions of brachial cuff inflation to 200 mmHg for five minutes following deflation to 0 mmHg for another five minutes. The procedure overall took 30 minutes. RIC is performed at inclusion and repeated 12 h and 24 h later. Sublingual microcirculatory measurements are obtained before and after each RIC procedure, using incidence dark field (IDF) device.

Inclusion Criteria:

• Patients with sepsis or septic shock within the first 24 h after ICU admission.

Exclusion Criteria:

• age < 18 years,
• pregnancy,
• advanced malignancy,
• peripheral artery disease affecting both arms,
• oral mucosal inflammation or injury or technical difficulties in obtaining sublingual images.