Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Berg-Copas G, Nyberg S, Baumchen J, Gurss E, Hennes E, Harrison P. Crit Care Med. 2008;36(12, Abstract Supplement):A52. Abstract 221.
Introduction: Immobilization of patients utilizing rigid spine boards (RSB) is standard practice in the management of trauma patients. ATLS guidelines recommend spine board immobilization until spine injury is excluded. Pressure ulcers (PU) have been associated with prolonged immobilization. The possibility exists that PU formation may begin when the patient is initially immobilized, the effects not fully recognized because of limited research on the direct tissue effects of prolonged immobilization. Near-infrared spectroscopy is an emerging tool to measure peripheral tissue oxygenation (StO2). The purpose of this pilot study was to study the effects of prolonged spinal immobilization on sacral tissue oxygenation of healthy volunteers.
Hypothesis: Methods: This cross-sectional study measured tissue oxygenation (StO2) in participants at before and after 30 minutes of immobilization on a RSB at two sites: sacral area (intervention) and 8-10 cm above sacral area (control). StO2 was measured with the InSpectra™ Tissue Oxygenation Monitor (Hutchinson Technology®) by placing the probe at the measurement site and waiting for 15 seconds for equilibration.
Results: Seventy three participants were included; most were female (55%), average age 38 years, average height 170 cm, and average weight 81 kg. There was a significant increase in the StO2 percentage at the sacral (intervention) area following immobilization, p < .001, rpb = .48. No significant changes in oxygenation was noted at the control site.
Conclusions: An increase in sacral tissue oxygenation following immobilization was an unexpected finding and may be a result of initial, rapid tissue reperfusion at the time of pressure release and the inability of this methodology to detect hypoperfusion during tissue compression. If tissue damage resulting in an increased rate of PU formation is associated with compression, it is not well known if this results from tissue hypoperfusion or rapid reperfusion.