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Changes in tissue oxygen saturation reflect changes in targeted oxygen delivery in postoperatively optimised patients
Critical Care volume 11, Article number: P271 (2007)
Introduction
Targeting oxygen delivery in the postoperative period has been shown to reduce hospital length of stay and complications [1]. Using a near-infrared spectroscopy device such as the Inspectraâ„¢ 325 allows the measurement of tissue oxygen saturation (STO2) noninvasively as well as a rudimentary measure of blood flow beneath the probe. It is plausible, then, that changes in oxygen delivery (DO2) during postoperative optimisation may be reflected in changes in STO2 and provide a noninvasive surrogate of DO2.
Methods
All adult patients admitted to the ICU after surgery who underwent protocolised haemodynamic optimisation were included. All patients had STO2 recorded over the thenar eminence using an Inspectraâ„¢ 325 for the first 8 hours of their stay.
Results
We found a significant correlation between the changes in STO2 and oxygen delivery index (DO2I) over the first 8 hours of intensive care stay (n = 40, correlation coefficient of 0.947, P = 0.0001, Figure 1). We classified patients who achieved DO2I > 600 ml/min/m2 as responders. These responders had higher STO2 values by 3 hours of optimisation, a change that remained significant throughout the duration of the study (Figure 2).
Conclusion
Changes in STO2 during postoperative optimisation appear to mirror changes in DO2I and may allow more widespread use of noninvasive tissue oxygenation devices in surgical optimisation.
References
Pearse , et al.: Early goal-directed therapy after major surgery reduces complications and duration of hospital stay. Crit Care 2005, 9: R687-R693. 10.1186/cc3887
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Hamilton, M., Canete, M., Cecconi, M. et al. Changes in tissue oxygen saturation reflect changes in targeted oxygen delivery in postoperatively optimised patients. Crit Care 11 (Suppl 2), P271 (2007). https://doi.org/10.1186/cc5431
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DOI: https://doi.org/10.1186/cc5431