scholarly journals Incidence of a low tissue oxygen saturation in a mixed population of critically ill patients

Critical Care ◽  
2010 ◽  
Vol 14 (Suppl 1) ◽  
pp. P151 ◽  
Author(s):  
A Veening ◽  
C Ince ◽  
J Bakker
Keyword(s):  
Oxygen Saturation ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mixed Population ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen

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.

scholarly journals Quantifying dermal microcirculatory changes of neuropathic and neuroischemic diabetic foot ulcers using spatial frequency domain imaging: a shade of things to come?

2020 ◽  
Vol 8 (2) ◽  
pp. e001815
Author(s):  
Grant A Murphy ◽  
Rajinder P Singh-Moon ◽  
Amaan Mazhar ◽  
David J Cuccia ◽  
Vincent L Rowe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Spatial Frequency ◽  
Oxygen Saturation ◽  
Diabetic Foot ◽  
Clinical Course ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen ◽  
Spatial Frequency Domain Imaging ◽  
Patients With Diabetes ◽  
Spatial Frequency Domain

IntroductionThe use of non-invasive vascular and perfusion diagnostics are an important part of assessing lower extremity ulceration and amputation risk in patients with diabetes mellitus. Methods for detecting impaired microvascular vasodilatory function in patients with diabetes may have the potential to identify sites at risk of ulceration prior to clinically identifiable signs. Spatial frequency domain imaging (SFDI) uses patterned near-infrared and visible light spectroscopy to determine tissue oxygen saturation and hemoglobin distribution within the superficial and deep dermis, showing distinct microcirculatory and oxygenation changes that occur prior to neuropathic and neuroischemic ulceration.Research designs and methods35 patients with diabetes mellitus and a history of diabetic foot ulceration were recruited for monthly imaging with SFDI. Two patients who ulcerated during the year-long longitudinal study were selected for presentation of their clinical course alongside the dermal microcirculation biomarkers from SFDI.ResultsPatient 1 developed a neuropathic ulcer portended by a focal increase in tissue oxygen saturation and decrease in superficial papillary hemoglobin concentration 3 months prior. Patient 2 developed bilateral neuroischemic ulcers showing decreased tissue oxygen saturation and increased superficial papillary and deep dermal reticular hemoglobin concentrations.ConclusionsWounds of different etiology show unique dermal microcirculatory changes prior to gross ulceration. Before predictive models can be developed from SFDI, biomarker data must be correlated with the clinical course of patients who ulcerate while being followed longitudinally.Trial registration numberNCT03341559.

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