Document Detail


Thenar Oxygen Saturation (StO2) and Invasive Oxygen Delivery Measurements in Critically Ill Patients in Early Septic Shock.
MedLine Citation:
PMID:  21192279     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: This study was aimed to test the hypothesis that tissue hemoglobin oxygen saturation (StO2) measured non-invasively using near-infrared spectroscopy (NIRS) is a reliable indicator of global oxygen delivery (DO2) measured invasively using a pulmonary artery catheter (PAC) in patients with septic shock. DESIGN:: Prospective study. SETTING:: 26-bed medical-surgical ICU, at a university hospital. SUBJECTS:: Adult patients in septic shock who required PAC hemodynamic monitoring for resuscitation. INTERVENTIONS:: Transient ischemic challenge on the forearm. MEASUREMENTS:: After blood pressure normalization, hemodynamic and oximetric PAC variables and, simultaneously, steady-state StO2, and its changes from ischemic challenge (deoxygenation and reoxygenation rates). MAIN RESULTS:: Fifteen patients were studied. All the patients had a mean arterial pressure above 65 mmHg. The DO2 index (iDO2) range in the studied population was 215-674 mLO2/min/m. The mean mixed venous oxygen saturation (SvO2) value was 61 ± 10%, mean cardiac index (CI) 3.4 ± 0.9 L/min/m, and blood lactate 4.6 ± 2.7 mmol/L. Steady-state StO2 significantly correlated with iDO2, arterial and venous O2 content, and O2 extraction ratio. A StO2 cut-off value of 75% predicted iDO2 below 450 with a sensitivity (S) of 0.9, specificity (E) of 0.9. CONCLUSIONS:: In patients in septic shock and normalized MAP, low StO2 reflects extremely low iDO2. Steady-state StO2 does not correlate with moderately low iDO2, indicating poor sensitivity of StO2 to rule out hypoperfusion.
Authors:
Jaume Mesquida; Guillem Gruartmoner; Maria Luisa Martínez; Jordi Masip; Caroline Sabatier; Cristina Espinal; Antonio Artigas; Francisco Baigorri
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-9
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Critical Care Center. Hospital de Sabadell. CIBER Enfermedades Respiratorias. Institut Universitari Parc Tauli. Universitat Autonoma de Barcelona. Barcelona, Spain. 2Department of Medicine. Universitat Autonoma de Barcelona.
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