Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Simon T, Schuerholz T, Petzel P Haugvik S, Klinzing S, Marx G. Int Care Med. 2007;33(Supp 2):S31. Abstract 0105.
Introduction: Microcirculatory dysfunction leads to inadequate tissue oxygenation and multi organ failure during sepsis or septic shock. Aim of this study was to compare non-invasive assessment of tissue oxygen saturation (StO2) with systemic oxygenation using mixed venous oxygen saturation (SvO2) as an indicator in an established model of porcine septic shock.
Methods: In a prospective animal study 20 anaesthetised, ventilated pigs (28.2 ± 2.1 kg) were investigated. Animals received 1g/kg/body weight faeces into abdominal cavity to induce sepsis and were observed over 8 hours. Volume therapy was administered to maintain a central venous pressure of 12 mmHg. SvO2 measured by CO-Oxymetry (Radiometer, Copenhagen) was obtained hourly after induction of sepsis. At the same time quadriceps muscle StO2 was measured by near-infrared spectroscopy (NIRS) (InSpectraTM, Hutchinson, USA). Correlation was analyzed by linear regression analysis.
Results: A total of 136 measurements were performed in 20 animals. StO2 was significantly correlated with the SvO2. r = 0.52 (r2 = 0.27) (p<0.01) and y = 0,32x + 43,6. Comparing the change in StO2 and SvO2 of two successive measurements reveals a correlation of r = 0.19 (r2 = 0.035) (p<0.05). Changes in StO2 and SvO2 were parallel in 47% of two successive measurements (both measurements changed at the same time in the same direction).
Conclusion: Although there is a significant correlation between StO2 and SvO2 in our experimental septic shock model, paired StO2 and SvO2 changed in the same direction only in 47%. Thus, SvO2 may not be estimated on the basis of StO2 in treatment of experimental septic shock and tissue oxygenation may not be estimated on the basis of SvO2 either. Whether a combination of StO2 and systemic oxygenation measurements is a useful monitoring approach in sepsis needs to be revealed.
Grant Acknowledgement: Inspectra device was provided by Hutchinson.