scholarly journals Low tissue oxygen saturation at the end of early goal-directed therapy is associated with worse outcome in critically ill patients

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 5) ◽  
pp. S13 ◽  
Author(s):  
Alexandre Lima ◽  
Jasper van Bommel ◽  
Tim C Jansen ◽  
Can Ince ◽  
Jan Bakker
Keyword(s):  
Oxygen Saturation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Goal Directed Therapy ◽  
Early Goal Directed Therapy

scholarly journals Oxygen Tissue Saturation Is Lower in Nonsurvivors than in Survivors after Early Resuscitation of Septic Shock

2009 ◽  
Vol 111 (2) ◽  
pp. 366-371 ◽  
Author(s):  
Marc Leone ◽  
Sami Blidi ◽  
François Antonini ◽  
Bertrand Meyssignac ◽  
Sébastien Bordon ◽  
...  
Keyword(s):  
Septic Shock ◽  
Oxygen Saturation ◽  
Tissue Oxygenation ◽  
Microvascular Dysfunction ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Goal Directed Therapy ◽  
Early Goal Directed Therapy ◽  
Hemodynamic Variables ◽  
Central Venous Saturation

Background Growing evidence suggests that the microvascular dysfunction is the key element of the pathogenesis of septic shock. This study's purpose was to explore whether the outcome of septic shock patients after early resuscitation using early goal-directed therapy is related to their muscle tissue oxygenation. Methods Tissue oxygen saturation (Sto2) was monitored in septic shock patients using a tissue spectrometer (InSpectra Model 325; Hutchinson Technology, Hutchinson, MN). For the purpose of this retrospective study, the Sto2 values were collected at the first measurement done after the macrohemodynamic variables (mean arterial pressure, urine output, central venous saturation in oxygen) were optimized. Results After the hemodynamic variables were corrected, no difference was observed between the nonsurvivors and survivors, with the exception of pulse oximetry saturation (94% [92-97%] vs. 97% [94-99%], P = 0.04). The Sto2 values were significantly lower in the nonsurvivors than in the survivors (73% [68-82%] vs. 84% [81-90%], P = 0.02). No correlations were found between the Sto2 and Spo2 (P = 0.7). Conclusions In septic shock patients, tissue oxygen saturation below 78% is associated with increased mortality at day 28. Further investigations are required to determine whether the correction of an impaired level of tissue oxygen saturation may improve the outcome of these patients.

Peripheral Perfusion Index Predicts Hypotension during Fluid Withdrawal by Continuous Veno-Venous Hemofiltration in Critically Ill Patients

2015 ◽  
Vol 40 (1) ◽  
pp. 92-98 ◽  
Author(s):  
Eva Klijn ◽  
A.B. Johan Groeneveld ◽  
Michel E. van Genderen ◽  
Michiel Betjes ◽  
Jan Bakker ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Perfusion Index ◽  
Tissue Oxygen Saturation ◽  
Peripheral Perfusion ◽  
Tissue Oxygen ◽  
Infra Red ◽  
Hypovolemic Hypotension

Aim: Peripheral perfusion may predict harmful hypovolemic hypotension during fluid withdrawal by continuous veno-venous hemofiltration (CVVH) in critically ill patients with acute kidney injury. Methods: Twenty-three critically ill AKI patients were subjected to progressive fluid withdrawal. Systemic hemodynamics and peripheral perfusion index (PPI) by pulse oximetry, forearm-to-fingertip skin temperature gradient (Tskin-diff) and tissue oxygen saturation (StO2, near infra-red spectroscopy) were measured. Results: Most hemodynamic values decreased with fluid withdrawal, particularly in the hypotensive group, except for stroke volume (SV) and cardiac output, which decreased to a great extent in the non-hypotensive patients. Increases in systemic vascular resistance (SVR) were less in hypotension. Baseline pulse pressure and PPI were lower in hypotensive (n = 10) than non-hypotensive patients and subsequent PPI values paralleled SV decreases. A baseline PPI ≤0.82 AU predicted hypotension with a sensitivity of 70%, and a specificity of 92% (AUC 0.80 ± 0.11, p = 0.004). Conclusion: Progressive fluid withdrawal during CVVH is poorly tolerated in patients with less increases in SVR. The occurrence of hypotension can be predicted by low baseline PPI.

scholarly journals Skeletal Muscle Oxygen Saturation (StO2) Measured by Near-Infrared Spectroscopy in the Critically Ill Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
J. Mesquida ◽  
G. Gruartmoner ◽  
C. Espinal
Keyword(s):  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Critically Ill ◽  
Near Infrared Spectroscopy ◽  
Critically Ill Patients ◽  
Near Infrared ◽  
New Technologies ◽  
Tissue Oxygen Saturation ◽  
Muscle Oxygen ◽  
Flow Variables

According to current critical care management guidelines, the overall hemodynamic optimization process seeks to restore macrocirculatory oxygenation, pressure, and flow variables. However, there is increasing evidence demonstrating that, despite normalization of these global parameters, microcirculatory and regional perfusion alterations might occur, and persistence of these alterations has been associated with worse prognosis. Such observations have led to great interest in testing new technologies capable of evaluating the microcirculation. Near-infrared spectroscopy (NIRS) measures tissue oxygen saturation (StO2) and has been proposed as a noninvasive system for monitoring regional circulation. The present review aims to summarize the existing evidence on NIRS and its potential clinical utility in different scenarios of critically ill patients.

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
Keyword(s):  
Oxygen Saturation ◽  
Critically Ill ◽  
Near Infrared ◽  
Tissue Perfusion ◽  
Integrative Review ◽  
Tissue Oxygen Saturation ◽  
Future Research ◽  
Tissue Oxygen ◽  
Critically Ill Adults ◽  
Ill Adults

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.

Sign in / Sign up

Export Citation Format

Share Document