Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Sagraves SG, Newell MA, Bard MR, Watkins F, Corcoran K, McMullen D, Rotondo MF. EAST Annual Scientific Assembly; January 13-17, 2009; Orlando, FL.
|
|
First StO2 |
Avg StO2 |
Min StO2 |
|
Mean ¡¾ SD (N=) | |||
|
Died (5) |
61.8 ¡¾ 28.4 |
58.1 ¡¾ 31.2 |
53.2 ¡¾ 32.5 |
|
Lived (36) |
82.2 ¡¾ 8.1 |
81.7 ¡¾ 7.4 |
76.3 ¡¾ 8.0 |
|
p-value |
0.0483 |
0.0904 |
0.1945 |
|
#Died/# lived |
5/36 |
5/36 |
5/36 |
|
p-value |
0.0637 |
0.0476 |
0.0423 |
|
Odds ratio %= 10 decrease |
3.08 |
2.74 |
2.28 |
Objective: The Hutchinson InSpectra tissue¢â oxygen saturation (StO2) monitor was created in the pursuit of a technique to assess perfusion status. It utilizes near infrared light to directly measure oxygen saturation in the microcirculation. Previous studies identify a StO2 of < 75% consistent with hypoperfusion. Its use in the pre-hospital setting for trauma patients has yet to be evaluated. A pilot study was undertaken to assess its ease of use by pre-hospital providers and to correlate measurements with patient outcomes.
Methods: All hospital based helicopters and long transport ambulances were equipped with StO2 monitoring devices after all pre-hospital providers were in-serviced on its use. Providers were asked to complete a survey on functionality and ease of use. Data collected from the monitor was recorded. Initial, average, and minimal StO2 (endpoints) were identified for all patients. Patient outcome data was obtained from the trauma registry. A logistic regression model was used to identify any correlation between StO2 endpoints and outcome.
Results: Forty-five of 55 (82%) questionnaires were completed with 100% reporting ease of use and 0% reporting interference with monitors or avionics. Monitoring length averaged 16.9 ¡¾ 6.9 minutes. Forty-one patients had complete data sets for evaluation. Mortality was 5/41 (12%). The average ISS was 18.06 ¡¾ 14.12. StO2 endpoints between groups with an ISS ¡Â or > 25 were significant. StO2 endpoints revealed an increased risk of death with every 10% decrease in StO2.
Conclusion: The StO2 monitor can easily be used in the pre-hospital environment. In addition, initial recordings were significantly different between survivors and non-survivors with every 10% decrease increasing mortality threefold.