Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Heyer L, Rezlan E, Madadaki C, Payen D. Society of Critical Care Medicine 31st Critical Care Congress; January 26-30, 2002; San Diego, CA.
Introduction: Near Infrared Spectroscopy (NIRS) has shown decreased thenar muscle tissue oxygen saturation reflecting the presence of severe hypoperfusion related to septic shock and trauma2,3. Here we compare the tissue hemoglobin oxygen saturation (Sto2) dynamics in post-partum hemorrhagic shock patients to septic patients.
Methods: NIRS (Inspectra™Tissue Spectrometer, Hutchinson Technology Inc.) was performed on the left thenar eminence of healthy volunteers (13), women diagnosed with post-partum hemorrhagic shock (19) and septic shock patients (29). All patients had been resuscitated before the first measurement. An occlusion (>210 mm Hg) was applied on the left arm until Sto2 values had dropped until Sto2 =40, upon which the occlusion was removed.
Results: Average Sto2 values before occlusion did not differ significantly between groups. However, a significant slower decline in StO2 is observed during the occlusion in both patient groups. In addition, a significant weaker increase in the StO2 after release of the occlusion is observed in the septic patients.
Discussion: Muscle tissue oxygen consumption in hemorrhagic shock patients and septic patients is slower after one day resuscitation. Muscle microvascular reactivity in hemorrhagic shock patients may not be altered while septic patients do show a microvascular alteration after occlusion hypoxia.
Conclusion: The Inspectra Tissue Spectrometer provides an excellent non-invasive method for detecting anomalies in tissue oxygen levels in severely ill patients.