Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Hamilton M, Canete M, Cecconi M, Al-subaie N, Vercuil A, Fawcett J, Dawson D, Rhodes A. Crit Care. 2007;11(Supp 2):S111. Abstract P271.
Introduction: Targeting oxygen delivery in the post-operative period has been shown to reduce hospital length of stay and complications(1). Using a near infra-red spectroscopy device such as the Inspectra™ 325 allows the measurement of tissue oxygen saturation non-invasively as well as a rudimentary measure of blood flow beneath the probe . It is plausible then that changes in Oxygen delivery (DO2) during post-operative optimisation may be reflected in changes in tissue oxygen saturation (STO2) and provide a non-invasive surrogate of oxygen delivery.
Methods: All adult patients admitted to the intensive care unit after surgery who underwent protocolised haemodynamic optimisation were included. All patients had tissue oxygen saturation recorded over the thenar eminence using an Inspectra™ 325 for the first 8 hours of their stay.
Results: We found a significant correlation between the changes in STO2 and DO2I over the first 8 hours of intensive care stay(n=40,correlation coefficient of 0.947, p = 0.0001, Fig. 1). We classified patients who achieved a DO2I of > 600 mls/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 (Fig. 2).
Conclusion: Changes in STO2 during post-operative optimisation appear to mirror changes in DO2I and may allow more widespread use of non-invasive tissue oxygenation devices in surgical optimisation. (1) Pearse et al Early goal-dirrected therapy after major surgery reduces complications and duration of hospital stay. Crit Care 2005; 9(6):R687-R6