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Characterization of tissue oxygen saturation and the vascular occlusion test: influence of measurement sites, probe sizes and deflation thresholds.

Gómez, H and Mesquida, J and Simon, P and Kim, HK and Puyana, JC and Ince, C and Pinsky, MR (2009) Characterization of tissue oxygen saturation and the vascular occlusion test: influence of measurement sites, probe sizes and deflation thresholds. Critical care (London, England), 13 Sup.

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Abstract

INTRODUCTION: Tissue oxygen saturation (StO2) and the vascular occlusion test (VOT) can identify tissue hypoperfusion in trauma and sepsis. However, the technique is neither standardized nor uses the same monitoring site. We hypothesized that baseline and VOT StO2 would be different in the forearm (F) and thenar eminence (TH) and that different minimal StO2 values during the VOT would result in different reoxygenation rates (ReO2). METHODS: StO2 and its change during the VOT were simultaneously measured in the F and TH, with 15 mm and 25 mm probes, using the 325 InSpectra monitor in 18 healthy, adult volunteers. Two VOTs were done to a threshold thenar StO2 of 40% interchanging the 15 mm and 25 mm probes between sites. Two additional VOTs were done to thresholds of 50% and 30%. Baseline StO2 (BaseO2), the deoxygenation rate (DeO2) and ReO2 were compared between sites, probes and (%O2/minute) thresholds. Results are presented as the median (interquartile range), P-value. RESULTS: BaseO2, DeO2, ReO2, area under the curve and hyperemia duration values were different when comparing TH vs. F and 15 mm vs. 25 mm probes. ReO2 was different between different thresholds for the TH and 15 mm probes. TH15 mm vs. F15 mm: BaseO2, 90.4 (85.2, 93.5) vs. 85.2 (80.7, 90.2), P = 0.031; DO2, -12.1 (-16.2, -11.3) vs. -8.5 (-10.3, -7.8), P = 0.011; ReO2, 297.2 (213.7, 328.6), P < 0.0001; 15 mm vs. 25 mm probe: BaseO2, 97.2 (89.4, 94.7) vs. 87.3 (81.7, 90.9), P = 0.016; DeO2, -18.0 (-24.1, -14.8) vs. -9.9 (-15.3, -6.5), P < 0.0001; and ReO2, 401.6 (331.7, 543.2) vs. 160.5 (132.3, 366.9), P = 0.012, respectively. TH15 mm vs. TH25 mm: BaseO2, P = 0.020; DeO2, P < 0.0001; and ReO2, P < 0.0001. Threshold StO2 values (15 mm probe only): ReO2, P = 0.003; DeO2, P = 0.60. ReO2 at 40% and 50% StO2 thresholds, P = 0.01. CONCLUSIONS: BaseO2, DeO2 and ReO2 were different when measured in different anatomical sites (F and TH) and with different probe sizes, and ReO2 was different with differing VOT release StO2 threshold values. Thus, standardization of the site, probe and VOT challenge need to be stipulated when reporting data.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Gómez, H
Mesquida, J
Simon, Ppms16@pitt.eduPMS16
Kim, HKhyk11@pitt.eduHYK11
Puyana, JC
Ince, C
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 January 2009
Date Type: Publication
Journal or Publication Title: Critical care (London, England)
Volume: 13 Sup
DOI or Unique Handle: 10.1186/cc8001
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
PubMed Central ID: PMC2786105
PubMed ID: 19951387
Date Deposited: 07 Mar 2012 20:15
Last Modified: 23 Nov 2021 21:55
URI: http://d-scholarship.pitt.edu/id/eprint/11337

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