Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Creteur J, Vincent JL. Intl J Int Care. 2008;Summer:19-22.
Severe sepsis causes microcirculatory alterations resulting in maldistribution of oxygen delivery within the tissues and subsequent local tissue hypoperfusion, a process leading to multiple organ dysfunction and death. Probably the most important goal of haemodynamic monitoring is the detection of inadequate tissue perfusion. The use of simple, non-invasive monitoring techniques has the advantage of facilitating earlier initiation of therapy. Near infrared spectroscopy (NIRS) technology has been proposed as a tool to monitor tissue oxygenation (StO2) and quantify microvascular dysfunction in acutely ill patients. Although some studies have reported lower StO2 values in septic patients than in healthy volunteers, the usefulness of single StO2 measurements in sepsis is not yet well established. In particular, the time course of the StO2 response during shock and resuscitation needs to be better understood. Here we review our current knowledge about the applicability, usefulness and limitations of NIRS as a technique to evaluate muscle oxygenation and microvascular dysfunction in patients with severe sepsis and assess its potential to guide the management of critically ill patients.