The following is a summary of “Potential of acetaminophen on the sublingual microcirculation and peripheral tissue perfusion of febrile septic patients: prospective observational study,” published in the February 2024 issue of Critical Care by Domizi et al.
Acetaminophen (ACT) shows promise in protecting septic patients with high cell-free hemoglobin (Hb) by potentially mitigating oxidative damage and improving endothelial function.
Researchers conducted a retrospective study to assess whether ACT impacts sublingual microcirculation and peripheral tissue perfusion in febrile septic and septic shock patients, aiming to inform clinical decision-making.
They involved 50 adult septic and septic shock patients treated with ACT for fever. Sublingual microcirculation and peripheral tissue perfusion were evaluated using Near Infrared Spectroscopy (NIRS) and vascular occlusion test (VOT) at three-time points. Before ACT (t0), after 30 minutes (t1), and after 2 hours (t2). Cell-free Hb, oxidative stress markers, and endothelial damage at t0 and t2 were also measured.
The results showed a notable rise in perfused small and total vessel density in the sublingual microcirculation 30 minutes after ACT infusion. Additionally, there was an increase in the Microvascular Flow Index (MFI) and a reduction in flow heterogeneity. An accelerated reperfusion curve was observed after VOT at t1 at the peripheral muscular level, indicating heightened microvasculature reactivity.
Investigators concluded that while ACT didn’t directly influence cell-free Hb, it improved microcirculation, particularly in septic patients, warranting further investigation.
Source: annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01251-z
