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Near-infrared spectroscopy-derived tissue oxygen saturation in battlefield injuries: a case series report.

Beilman GJ, Blondet JJ - World J Emerg Surg (2009)

Bottom Line: During the above time period, 161 patients were evaluated at the CSH as a result of traumatic injury and the device was placed on approximately 40 patients.In most patients, StO2 readings of greater than 70% were noted during the initial evaluation.In 8 patients, convenience samples of StO2 data were collected along with pertinent physiologic data.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Surgical Critical Care/Trauma, Department of Surgery, University of Minnesota, MMC 11, 420 Delaware St SE, Minneapolis, Minnesota 55455, USA. blond006@umn.edu.

ABSTRACT

Background: Near-infrared spectroscopy technology has been utilized to monitor perfusion status in animal models of hemorrhagic shock and in human traumatic injury. To observe the effectiveness of such a device in a combat setting, an FDA-approved device was used in conjunction with standard resuscitation and therapy of wounded patients presenting to the 228th Combat Support Hospital (CSH), Company B, over a three-month period.

Materials and methods: These observations were performed on patients presenting to the 228th CSH, Co B, at Forward Operating Base Speicher, outside of Tikrit, Iraq, between the dates of June 15 and September 11, 2005. We utilized the Inspectra 325 tissue oxygen saturation (StO2) monitor (Hutchinson Technology, Inc; Hutchinson, MN, USA) with the probe placed on the thenar eminence or on another appropriate muscle bed, and used to monitor StO2 during early resuscitation and stabilization of patients.

Results: During the above time period, 161 patients were evaluated at the CSH as a result of traumatic injury and the device was placed on approximately 40 patients. In most patients, StO2 readings of greater than 70% were noted during the initial evaluation. No further information was collected from these patients. In 8 patients, convenience samples of StO2 data were collected along with pertinent physiologic data. In these patients, StO2 levels of below 70% tracked with hypotension, tachycardia, and clinical shock resulted in increases in StO2 after resuscitation maneuvers.

Conclusion: Near-infrared spectroscopy-derived StO2 reflected and tracked the resuscitation status of our patients with battlefield injuries. StO2 has significant potential for use in resuscitation and care of patients with battlefield injuries.

No MeSH data available.


Related in: MedlinePlus

StO2 is derived from measurement of the near-infrared spectra of the tissue bed sampled. A near-infrared light source shines light into the tissue bed. A spectrum, measured using reflectance of near-infrared light, is used to measure the percentage of hemoglobin saturation.
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Figure 1: StO2 is derived from measurement of the near-infrared spectra of the tissue bed sampled. A near-infrared light source shines light into the tissue bed. A spectrum, measured using reflectance of near-infrared light, is used to measure the percentage of hemoglobin saturation.

Mentions: Near-infrared (NIR) spectroscopy utilizes fiber-optic light to non-invasively determine the percentage of oxygen saturation of chromophores (e.g. hemoglobin) based on spectrophotometric principles [2]. This technology has been utilized to experimentally determine regional tissue oxygen saturation (StO2) [3-5] by monitoring the differential tissue optical absorbance of near-infrared light. Unlike pulse oximetry, NIR spectroscopy measures not only arterial, but also venous oxyhemoglobin saturation at the microcirculatory level (Figure 1). This measurement therefore is a reflection of both oxygen delivery (DO2) and oxygen consumption (VO2) of the tissue bed sampled [6,7]. Non-invasive determination of these parameters using NIR spectroscopy has been described as has its correlation with DO2 and mixed venous oxygen saturation (SvO2) [3-7]. NIR-derived StO2 has been demonstrated to be predictive of severity of shock states in an animal model of hemorrhagic shock [8].


Near-infrared spectroscopy-derived tissue oxygen saturation in battlefield injuries: a case series report.

Beilman GJ, Blondet JJ - World J Emerg Surg (2009)

StO2 is derived from measurement of the near-infrared spectra of the tissue bed sampled. A near-infrared light source shines light into the tissue bed. A spectrum, measured using reflectance of near-infrared light, is used to measure the percentage of hemoglobin saturation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2714076&req=5

Figure 1: StO2 is derived from measurement of the near-infrared spectra of the tissue bed sampled. A near-infrared light source shines light into the tissue bed. A spectrum, measured using reflectance of near-infrared light, is used to measure the percentage of hemoglobin saturation.
Mentions: Near-infrared (NIR) spectroscopy utilizes fiber-optic light to non-invasively determine the percentage of oxygen saturation of chromophores (e.g. hemoglobin) based on spectrophotometric principles [2]. This technology has been utilized to experimentally determine regional tissue oxygen saturation (StO2) [3-5] by monitoring the differential tissue optical absorbance of near-infrared light. Unlike pulse oximetry, NIR spectroscopy measures not only arterial, but also venous oxyhemoglobin saturation at the microcirculatory level (Figure 1). This measurement therefore is a reflection of both oxygen delivery (DO2) and oxygen consumption (VO2) of the tissue bed sampled [6,7]. Non-invasive determination of these parameters using NIR spectroscopy has been described as has its correlation with DO2 and mixed venous oxygen saturation (SvO2) [3-7]. NIR-derived StO2 has been demonstrated to be predictive of severity of shock states in an animal model of hemorrhagic shock [8].

Bottom Line: During the above time period, 161 patients were evaluated at the CSH as a result of traumatic injury and the device was placed on approximately 40 patients.In most patients, StO2 readings of greater than 70% were noted during the initial evaluation.In 8 patients, convenience samples of StO2 data were collected along with pertinent physiologic data.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Surgical Critical Care/Trauma, Department of Surgery, University of Minnesota, MMC 11, 420 Delaware St SE, Minneapolis, Minnesota 55455, USA. blond006@umn.edu.

ABSTRACT

Background: Near-infrared spectroscopy technology has been utilized to monitor perfusion status in animal models of hemorrhagic shock and in human traumatic injury. To observe the effectiveness of such a device in a combat setting, an FDA-approved device was used in conjunction with standard resuscitation and therapy of wounded patients presenting to the 228th Combat Support Hospital (CSH), Company B, over a three-month period.

Materials and methods: These observations were performed on patients presenting to the 228th CSH, Co B, at Forward Operating Base Speicher, outside of Tikrit, Iraq, between the dates of June 15 and September 11, 2005. We utilized the Inspectra 325 tissue oxygen saturation (StO2) monitor (Hutchinson Technology, Inc; Hutchinson, MN, USA) with the probe placed on the thenar eminence or on another appropriate muscle bed, and used to monitor StO2 during early resuscitation and stabilization of patients.

Results: During the above time period, 161 patients were evaluated at the CSH as a result of traumatic injury and the device was placed on approximately 40 patients. In most patients, StO2 readings of greater than 70% were noted during the initial evaluation. No further information was collected from these patients. In 8 patients, convenience samples of StO2 data were collected along with pertinent physiologic data. In these patients, StO2 levels of below 70% tracked with hypotension, tachycardia, and clinical shock resulted in increases in StO2 after resuscitation maneuvers.

Conclusion: Near-infrared spectroscopy-derived StO2 reflected and tracked the resuscitation status of our patients with battlefield injuries. StO2 has significant potential for use in resuscitation and care of patients with battlefield injuries.

No MeSH data available.


Related in: MedlinePlus