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Near-infrared spectroscopy for assessing the tissue oxygen extraction rate during sepsis: relationship with outcome
Critical Care volume 19, Article number: P143 (2015)
Microcirculatory dysfunction impairs tissue oxygenation during sepsis. We applied near-infrared spectroscopy (NIRS) to evaluate the tissue oxygen extraction rate in sepsis and its relationship with outcome.
A prospective observational study; 14 septic patients underwent NIRS monitoring (thenar eminence) with a vascular occlusion test (using a 40% StO2 target) at admission to the ICU. Healthy volunteers (n = 27) were studied as controls. The slope of the desaturation curve was assessed separately for the first (StO2 down1) and the last part (StO2 down2) of the curve and the difference between, Down2 - Down1, was calculated.
StO2 Down1 was lower in healthy volunteers as compared with septic patients (P < 0.05); no difference was seen between ICU survivors (n = 7) and nonsurvivors (n = 7). StO2 Down2 was similar between healthy volunteers and ICU survivors, while it was higher in nonsurvivors (P < 0.01 vs. healthy). ICU nonsurvivors showed higher Down2 - Down1 as compared with ICU survivors (P < 0.01, Figure 1).
Tissue oxygen extraction was reduced in septic patients. Nonsurvivors showed a flattening in the last part of the desaturation curve during a VOT, while the first part of the StO2 downslope did not show any difference between survivors and nonsurvivors. This may reflect a tissue hypometabolic status, which may be better elicited in the final part of the ischemic challenge.
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Donati, A., Damiani, E., Scorcella, C. et al. Near-infrared spectroscopy for assessing the tissue oxygen extraction rate during sepsis: relationship with outcome. Crit Care 19, P143 (2015). https://doi.org/10.1186/cc14223
- Healthy Volunteer
- Septic Patient
- Prospective Observational Study
- Final Part
- Vascular Occlusion