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Use of non-invasive NIRS during a vascular occlusion test to assess dynamic tissue O<inf>2</inf> saturation response

Gómez, H and Torres, A and Polanco, P and Kim, HK and Zenker, S and Puyana, JC and Pinsky, MR (2008) Use of non-invasive NIRS during a vascular occlusion test to assess dynamic tissue O<inf>2</inf> saturation response. Intensive Care Medicine, 34 (9). 1600 - 1607. ISSN 0342-4642

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Abstract

Introduction: We assessed tissue O2 saturation (StO2) and total hemoglobin (HbT) changes during a vascular occlusion test (VOT) as markers of O2 consumption and cardiovascular reserve. Methods: Using the non-invasive InSpectra® near infrared spectrometer, we studied the effect of VOT to StO2 < 40% then release on thenar eminence StO2 and HbT in 15 normal volunteers (controls) and 10 trauma patients. We repeated the VOT four times in controls and twice in patients, with controls exercising during the last VOT, and correlated StO 2 with HbT changes by linear regression analysis. Results: StO 2 started to decrease 3-28 s post-occlusion (latency) in controls and then decreased in a linear fashion (-0.18 ± 0.04% O2/s, mean ± SD), while post-occlusion StO2 recovery was rapid (5.20 ± 1.19% O2/s). Exercise decreased latency (0-5 s) and increased desaturation rate (-0.18 and -0.69% O2/s, P < 0.005) without altering recovery. Trauma patients showed similar StO2 desaturation rates, but slower recovery (5.20 ± 1.19 vs. 2.88 ± 1.71%/s, P < 0.0001). Repeated VOT gave similar recovery results within study groups. The hyperemic response was variable in both groups and, if present, was associated with an increased HbT. HbT pre- and post-VOT were significantly different within each subject. Although HbT slope of recovery correlated significantly with StO2 recovery in trauma patients (rho 0.76), it was not in controls. Conclusions: One VOT defines StO2 deoxygenation and recovery. That StO2 and HbT recovery co-vary only in trauma patients suggests that pre-existing vasoconstriction was unmasked by the ischemic challenge consistent with increased sympathetic tone. © 2008 Springer-Verlag.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Gómez, H
Torres, A
Polanco, P
Kim, HKhyk11@pitt.eduHYK11
Zenker, S
Puyana, JC
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 September 2008
Date Type: Publication
Journal or Publication Title: Intensive Care Medicine
Volume: 34
Number: 9
Page Range: 1600 - 1607
DOI or Unique Handle: 10.1007/s00134-008-1145-1
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0342-4642
PubMed ID: 18523754
Date Deposited: 07 Mar 2012 20:08
Last Modified: 31 Jul 2020 17:04
URI: http://d-scholarship.pitt.edu/id/eprint/11323

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