Sublingual High-Velocity Blood Flow at Hospital Admission is Associated with Incident Sepsis Within 48 Hours in Patients with Suspected Infection: A Prospective Observational Study
- 1Department of Critical Care Medicine, The Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People’s Republic of China
Abstract
Objective: To examine whether sublingual high-velocity blood flow (HVBF), assessed within 6 hours of hospital admission, is associated with incident sepsis (study-defined) within 48 hours in patients with suspected infection but without sepsis at admission.
Methods: In this prospective single-center observational study, hospitalized adults with suspected infection underwent sublingual sidestream dark field imaging within 6 hours of admission. HVBF positivity was predefined as a mean field-specific maximal red blood cell velocity ≥ 1000 μm/s. The primary cohort comprised 109 patients without sepsis at admission, of whom 59 developed incident sepsis within 48 hours. Associations were examined using multivariable logistic regression adjusted for the National Early Warning Score (NEWS) and lactate.
Results: HVBF positivity was present in 78.0% of patients who developed incident sepsis versus 26.0% of those who did not (crude odds ratio [OR] 10.07, 95% confidence interval [CI] 4.17–24.33, P < 0.001) and persisted after adjustment (adjusted OR 4.32, 95% CI 1.32–14.22, P = 0.016). HVBF showed lower discrimination than NEWS (area under the curve [AUC] 0.760 vs 0.887, P = 0.007), and adding HVBF to NEWS plus lactate did not improve discrimination (AUC 0.920 vs 0.917, P = 0.833). After additional adjustment for the admission Sequential Organ Failure Assessment (SOFA) score, the HVBF association became non-significant (OR 1.21, P = 0.813).
Conclusion: Sublingual HVBF positivity was associated with incident sepsis within 48 hours but was not independent of minor baseline organ dysfunction and added no incremental discrimination beyond NEWS and lactate. HVBF may represent a bedside-visible microcirculatory phenotype of the pre-criteria phase of the infection-to-sepsis trajectory.
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BibTeX
@article{yao2026sublingual,
title = {{Sublingual High-Velocity Blood Flow at Hospital Admission is Associated with Incident Sepsis Within 48 Hours in Patients with Suspected Infection: A Prospective Observational Study}},
author = {Yuantuan Yao and Bao Fu and Xiaoyun Fu},
journal = {Journal of Inflammation Research},
year = {2026},
month = oct,
doi = {10.2147/jir.s650685},
url = {https://doi.org/10.2147/jir.s650685},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Sublingual High-Velocity Blood Flow at Hospital Admission is Associated with Incident Sepsis Within 48 Hours in Patients with Suspected Infection: A Prospective Observational Study
AU - Yuantuan Yao
AU - Bao Fu
AU - Xiaoyun Fu
PY - 2026
DA - 2026/10/27
JO - Journal of Inflammation Research
DO - 10.2147/jir.s650685
UR - https://doi.org/10.2147/jir.s650685
AB - Objective: To examine whether sublingual high-velocity blood flow (HVBF), assessed within 6 hours of hospital admission, is associated with incident sepsis (study-defined) within 48 hours in patients with suspected infection but without sepsis at admission. Methods: In this prospective single-center observational study, hospitalized adults with suspected infection underwent sublingual sidestream dark field imaging within 6 hours of admission. HVBF positivity was predefined as a mean field-specific maximal red blood cell velocity ≥ 1000 μm/s. The primary cohort comprised 109 patients without sepsis at admission, of whom 59 developed incident sepsis within 48 hours. Associations were examined using multivariable logistic regression adjusted for the National Early Warning Score (NEWS) and lactate. Results: HVBF positivity was present in 78.0% of patients who developed incident sepsis versus 26.0% of those who did not (crude odds ratio [OR] 10.07, 95% confidence interval [CI] 4.17–24.33, P < 0.001) and persisted after adjustment (adjusted OR 4.32, 95% CI 1.32–14.22, P = 0.016). HVBF showed lower discrimination than NEWS (area under the curve [AUC] 0.760 vs 0.887, P = 0.007), and adding HVBF to NEWS plus lactate did not improve discrimination (AUC 0.920 vs 0.917, P = 0.833). After additional adjustment for the admission Sequential Organ Failure Assessment (SOFA) score, the HVBF association became non-significant (OR 1.21, P = 0.813). Conclusion: Sublingual HVBF positivity was associated with incident sepsis within 48 hours but was not independent of minor baseline organ dysfunction and added no incremental discrimination beyond NEWS and lactate. HVBF may represent a bedside-visible microcirculatory phenotype of the pre-criteria phase of the infection-to-sepsis trajectory.
SN - 1178-7031
ER -