Impaired skeletal muscle microvascular function and increased skeletal muscle oxygen consumption in severe falciparum malaria

Abstract

Background. Organ dysfunction and tissue hypoxia in severe falciparum malaria result from an imbalance between oxygen delivery and demand. In severe malaria, microvascular obstruction from parasite sequestration decreases oxygen delivery. However, host microvascular function (defined as the capacity to increase oxygen delivery in response to ischemia) and oxygen consumption have not been assessed.Methods. We used near-infrared resonance spectroscopy to measure thenar muscle microvascular function (StO2recov) and oxygen consumption (VO2) in 36 adults in Papua, Indonesia, with severe malaria, 33 with moderately severe malaria (MSM), 24 with severe sepsis, and 36 healthy controls.Results. In the severe malaria group, the StO2recov of 2.7%/second was 16% and 22% lower than that in the MSM group (3.1%/second) and control group (3.5%/second), respectively (P