THENAR OXYGEN SATURATION AND INVASIVE OXYGEN DELIVERY MEASUREMENTS IN CRITICALLY ILL PATIENTS IN EARLY SEPTIC SHOCK
This prospective study was aimed to test the hypothesis that tissue hemoglobin oxygen saturation (StO(2)) measured noninvasively using near-infrared spectroscopy is a reliable indicator of global oxygen delivery (DO2) measured invasively using a pulmonary artery catheter (PAC) in patients with septi...
| Autores: | , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2011 |
| País: | España |
| Institución: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repositorio: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p4673 |
| Acceso en línea: | https://i3pt.portalinvestigacion.com/publicaciones/4673 |
| Access Level: | acceso abierto |
| Palabra clave: | Microcirculation near-infrared spectroscopy hemodynamic monitoring tissue oxygenation |
| Sumario: | This prospective study was aimed to test the hypothesis that tissue hemoglobin oxygen saturation (StO(2)) measured noninvasively using near-infrared spectroscopy is a reliable indicator of global oxygen delivery (DO2) measured invasively using a pulmonary artery catheter (PAC) in patients with septic shock. The study setting was a 26-bed medical-surgical intensive care unit at a university hospital. Subjects were adult patients in septic shock who required PAC hemodynamic monitoring for resuscitation. Interventions included transient ischemic challenge on the forearm. After blood pressure normalization, hemodynamic and oximetric PAC variables and, simultaneously, steady-state StO(2) and its changes from ischemic challenge (deoxygenation and reoxygenation rates) were measured. Fifteen patients were studied. All the patients had a mean arterial pressure above 65 mmHg. The DO2 index (iDO(2)) range in the studied population was 215 to 674 mL O-2/min per m(2). The mean mixed venous oxygen saturation value was 61% +/- 10%, mean cardiac index was 3.4 +/- 0.9 L/min per m(2), and blood lactate level was 4.6 +/- 2.7 mmol/L. Steady-state StO(2) significantly correlated with iDO(2), arterial and venous O-2 content, and O-2 extraction ratio. A StO(2) cutoff value of 75% predicted iDO(2) below 450, with a sensitivity of 0.9 and a specificity of 0.9. In patients in septic shock and normalized MAP, low StO(2) reflects extremely low iDO(2). Steady-state StO(2) does not correlate with moderately low iDO(2), indicating poor sensitivity of StO(2) to rule out hypoperfusion. |
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