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We studied 24 severe sepsis subjects 24 h after recognition of organ dysfunction; 15 healthy subjects served as controls. Near-infrared spectroscopy (NIRS) was used to measure tissue 1) microvascular hemoglobin signal strength and 2) oxygen saturation of microvascular hemoglobin (StO2). Both values were measured in thenar skeletal muscle before and after 5 min of forearm stagnant ischemia. At baseline, skeletal muscle microvascular hemoglobin was lower in septic than control subjects. Microvascular hemoglobin increased during reactive hyperemia in both groups, but less so in sepsis. StO2 at baseline and throughout ischemia was similar between the two groups; however, the rate of tissue oxygen consumption was significantly slower in septic subjects than in controls. The rate of increase in StO2 during reactive hyperemia was significantly slower in septic subjects than in controls; this impairment was accentuated in those with more organ failure. We conclude that organ dysfunction in severe sepsis is associated with dysregulation of microvascular oxygen balance. NIRS measurements of skeletal muscle microvascular perfusion and reactivity may provide important information about sepsis and serve as endpoints in future therapeutic interventions aimed at improving the microcirculation. <\/jats:p>","DOI":"10.1152\/ajpheart.01237.2006","type":"journal-article","created":{"date-parts":[[2007,5,5]],"date-time":"2007-05-05T01:04:22Z","timestamp":1178327062000},"page":"H1065-H1071","source":"Crossref","is-referenced-by-count":202,"title":["Impairments in microvascular reactivity are related to organ failure in human sepsis"],"prefix":"10.1152","volume":"293","author":[{"given":"Kevin C.","family":"Doerschug","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela S.","family":"Delsing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory A.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William G.","family":"Haynes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199502000-00011"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(97)00132-6"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Bateman RM, Walley KR. 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