The predictive value on outcome for the StO2 reperfusion slope and SOFA score was calculated using a receiver operator characteristic curve with data obtained on day 1.All tests were two-sided, at the 0.05 significance level. Analyses were carried out using the before R statistical package [36].ResultsClinical characteristicsForty-three patients with septic shock were included in the study. Clinical characteristics are summarized in Table Table1.1. By definition, all patients had cardiovascular dysfunction and at least one other organ dysfunction at the time of recruitment. According to collegial decision, 11 patients (25.6%) received recombinant human activated protein C at the recommended dose rate and duration, 15 patients (34.

8%) received low-dose hydrocortisone (50 mg four times daily) with no fludrocortisone, and three patients (7%) were treated with nitric oxide donors (molsidomine, 2 to 4 mg; Sanofi Aventis, Paris, France) [10]. The age of the 15 healthy volunteers ranged from 25 to 72 years.Table 1Demographic and clinical characteristics of septic shock patientsThe actual mortality rate was 34.9% (15 patients), consistent with a group at high risk of death. Of these 15 nonsurviving patients, two (13.3%) received recombinant human activated protein C and four (26.6%) received hydrocortisone. There were no differences in age, sex, primary sites of infection or Simplified Acute Physiology Score II scores between survivors and nonsurvivors. The SOFA score on day 1, however, was higher in nonsurvivors compared with survivors (median 13 (12 to 16) vs. 9 (8 to 11), P = 0.

001).Among the hemodynamic parameters (Table (Table2),2), only cardiac output was significantly different between survivors and nonsurvivors (6.8 (5.0 to 8.3) vs. 4.9 (4.1 to 6.9), P = 0.04). The lactate level was higher in nonsurvivors compared with survivors (median 6.8 (5.3 to 8.8) vs. 3.1 (2 to 4), P = 0.001), while the pH and base excess were lower in the former group of patients than in those who survived (7.2 (7.1 to 7.2) vs. 7.3 (7.2 to 7.4), P < 0.001, and -12.3 (-14.25 to -10.4) vs. -7.3 (-10 to -3.8), P = 0.004, respectively) (Table (Table2).2). The hemoglobin concentration showed no difference between both groups (P = 0.51) and was considered adequate.Table 2Hemodynamic and metabolic data and severity scores at day 1The evolution of patients surviving at least the first 3 days is described in Table Table33 for the SOFA score, cardiovascular support, hemodynamic and metabolic items, StO2 and LD data. One can note the rapid evolution of the hemodynamic parameters, Cilengitide norepinephrine dose, metabolic status and StO2 parameters despite a relatively stable day-to-day SOFA score.