Please see Bibliography of References for a list of abstracts, manuscripts and posters.

Sepsis

Tissular oxygen saturation measured by near-infrared spectroscopy as a non-invasive predictor of low central venous oxygen saturation: a useful parameter in our resuscitation algorithm?

Mesquida J, Masip J, Gili G, Sabatier C, Baigorri F, Artigas A. Am J Respir Crit Care Med. 2008;177(Abstracts Issue):A366.

Objective: To validate tissular oxygen saturation (StO₂) measured by near-infrared spectroscopy (NIRS) as a non-invasive estimation of central venous saturation (SvcO2).

Methods: We prospectively studied 42 patients admitted to the ICU with early severe sepsis or septic shock after blood pressure normalization with fluids and/or vasoactive drugs. Demographic data, severity score, hemodynamics, lactate, SvcO2 and StO₂ were collected at inclusion time. We divided patients into two groups according to SvcO2 values: group A, with SvcO2 <70%, and group B, with SvcO2 ¡Ý70%.

Results: StO₂ was significantly lower in group A than in group B (74.7 ¡À13.0 vs 83.2 ¡À6.5, p 0.008). No differences in age, severity score, hemodynamics, vasoactive drugs and lactate were found between both groups. Simultaneously measured values for SvcO2 and StO₂ showed a significant Pearson correlation (r = 0.37, p 0.017). Using NIRS for detecting SvcO2 values lower than 70%, a StO₂ value of 75% showed a sensitivity of 0.44, especificity of 0.94, and a positive likelihood ratio of 7.3.

Conclusions: StO₂ correlates with SvcO2 in normotensive patients with severe sepsis or septic shock. We propose a StO₂ cut-off value of 75% as a rapid, non-invasive, first step for detecting low SvcO2 values in resuscitation algorithms.