All patients received useful site fluid challenge, and, if necessary, continuous infusion of inotropic (dobutamine) and vasopressor (norepinephrine) agents to maintain a normal cardiac index and intrathoracic blood volume index and to maintain the mean arterial pressure between 70 and 100 mmHg.Near-infrared spectroscopyStO2 was measured by a tissue spectrometer (InSpectra? Model 325; Hutchinson Technology Inc., Hutchinson, MN, USA). The spectrometer consists of light detection circuitry and an optical cable that transmits light to tissues and receives scattered light from tissues. The maximum depth of the tissue volume sampled is estimated to be equal to the distance between the sending and receiving fibers of the probe (probe spacing).

A probe spacing of 15 mm was used, with the probe placed on an adhesive surface on the skin of the volar surface of the forearm at the level of the brachio-radial muscle. The VOT was applied using a sphygmomanometer cuff around the same arm that was inflated to 60 mmHg above the systolic arterial pressure to obtain an arterial occlusion (stagnant ischemia) until StO2 decreased to 40%. StO2 was monitored continuously before (baseline) and during (ischemia) pneumatic compression and after cuff release (reperfusion).Data were analyzed using InSpectra? software to plot and measure the StO2 curve characteristics; that is, baseline StO2 (StO2 baseline), rate of decrease in StO2 during the VOT during the (StO2 downslope), and rate of increase in StO2 reperfusion phase (StO2 upslope).

Data were collected before (T0), during (24 hours (T1a), 48 hours (T1b), 72 hours (T1c), and 96 hours (T1d)), and 6 hours (T2) after rh-aPC treatment (that is, 102 hours from T0), and at the same times in the controls. At all time points (except at 96 hours) the following measurements were obtained: mean arterial pressure, dose of norepinephrine, arterial blood lactate and base excess, cardiac index and intrathoracic blood volume index, and SOFA score.Statistical analysisResults are expressed as the mean �� standard deviation, and as the median (first to third interquartile range) for catecholamines. Parametric statistics were applied for all parameters-except for catecholamines, for which nonparametric statistics were utilized.

A two-way analysis of variance test was used to assess differences between groups; a paired t test was applied to test differences between times Dacomitinib within each group, while an unpaired t test with Welch correction when indicated was applied to test differences at each time between groups. The Friedman test was used to test significant differences during time within each group, the Wilcoxon test was used to test differences between each time point and T0, and the Mann-Whitney U test was used to test for differences between groups. P < 0.05 was considered statistically significant.