Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Kierzek G, Didden S, Bonnetain F, Deville C, Pourriat JL. Anesthesiology. 2007;107:A1270.
Introduction: The INSPECTRA 325™ (from Hutchinson) tissue spectrometry system is a non-invasive technique that allows to assess the tissue oxygenation by continuously measuring the tissue HbO2 (%STO2) saturation. Pre-clinical and clinical studies using this technique have shown its usefulness in models of haemorrhagic shocks ressuscitation (Rhee P, Crit Care Med 1997; Beilman GJ, Shock 1999). As far as we know, there has been no study published on the advantage and feasability of using it in ICU with all types of patients as a parameter to define the orientation of these.
Equipment and Methods: Prospective study in an Emergency Department (45000 visits per year); inclusion criteria: all patients visiting the ED during the time the study is being carried out. Protocole: each patient, after information has been provided and consent given for inclusion in the study during their appointment, is evaluated right from the initial nurse consultation and orientation over and above all other parametres (PAS, PAD, SpO2, T°,FC).
Outcomes: 856 patients have had their STO2 measured. Out of these patients, 93 (11%) have been admitted to hospital and 763 (89%) have not been. A Kruskall Wallis test in order to assess the mean discrepancy between STO2 in the population admitted to hospital and the non-admitted one does not allow to positively conclude as to a difference (p = 0.2333). In contrast, for the sub-group referring to the most serious patients (n=13 ; final orientation in intensive or continuous care), the STO2 is significantly lower (68,62 vs 80,12 ; p<0,05).
Discussion: the STO2 can be easily achieved in ED by the initial nurse as soon as the patient is admitted. In univaried analysis, the most serious patients – who will eventually be admitted in ICU or in ressuscitation unit – have shown lower STO2 values than out-going patients. This new parametre could then allow an improved sorting of the patients and so at a very early stage (Golden hours of the sepsis for example), of all types of patients in ED.