scholarly journals Bedside Assessment of Tissue Oxygen Saturation Monitoring in Critically Ill Adults: An Integrative Review of the Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-19 ◽  
Author(s):  
Carol Diane Epstein ◽  
Karen Toby Haghenbeck

Objective. Tissue oxygen saturation (StO2) monitoring is a noninvasive technology with the purpose of alerting the clinician of peripheral hypoperfusion and the onset of tissue hypoxia. This integrative review examines the rigor and quality of studies focusing on StO2monitoring in adult critically ill patients.Background. Clinicians must rapidly assess adverse changes in tissue perfusion while minimizing potential complications associated with invasive monitoring. The noninvasive measurement of tissue oxygen saturation is based on near-infrared spectroscopy (NIRS), an optical method of illuminating chemical compounds which absorb, reflect, and scatter light directed at that compound.Methods. An integrative review was conducted to develop a context of greater understanding about complex topics. An Integrative review draws on multiple experimental and nonexperimental research methodologies.Results. Fourteen studies were graded at the C category. None reported the use of probability sampling or demonstrated a cause-and-effect relationship between StO2values and patient outcomes.Conclusions. Future research should be based on rigorous methods of sampling and design in order to enhance the internal and external validity of the findings.

2021 ◽  
Vol 7 ◽  
pp. 2513826X2110511
Author(s):  
Spencer Yakaback ◽  
Carmen Webb ◽  
Claire Temple-Oberle

Paramedian forehead flaps (PMFFs) are commonly performed procedures for the reconstruction of complex nasal defects and require multiple stages predicated on when the interpolated pedicle is no longer required to provide perfusion to the neo-nose. As the presence of the pedicle is disfiguring, the flap is therefore divided ideally as soon as safely possible, but that determination is challenging. Recently, a novel device that uses near-infrared spectroscopy (NIRS) to measure tissue oxygen saturation has been developed and may provide an accurate and cost-effective tool to assess tissue perfusion. Here we present the use of this technology in the management of 2 patients who underwent successful oncologic nasal reconstructions using PMFFs. Using the device as a clinical adjunct, we measured tissue oxygen saturation values in the flaps before and after pedicle division, which assisted us in deciding when to safely divide the flaps, as well as with post-division management, particularly when a low tissue oxygen saturation reading ultimately necessitated the use of nitroglycerine past to improve flap perfusion in one of our patients. Interestingly, the values we recorded corresponded well to previously published cut-off values for adequate tissue perfusion, which have to date only been reported for free flaps. To our knowledge, this is the first description of the use of NIRS in the division of PMFFs, which we overall found to be a useful and reliable adjunct to a clinical examination in assessing flap neovascularization.


Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P239
Author(s):  
R Kopp ◽  
S Rex ◽  
K Dommann ◽  
G Schälte ◽  
G Dohmen ◽  
...  

2016 ◽  
Vol 59 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Takaaki Watanabe ◽  
Masato Ito ◽  
Fuyu Miyake ◽  
Ryo Ogawa ◽  
Masanori Tamura ◽  
...  

2004 ◽  
Vol 36 (Supplement) ◽  
pp. S23-S24
Author(s):  
Jason G. Langley ◽  
Emily S. Murphy ◽  
Irma H. Ullrich ◽  
Amy Sindler ◽  
Rachel A. Yeater

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