Peripheral vasoconstriction influences thenar oxygen saturation as measured by near-infrared spectroscopy

被引:29
作者
Lima, Alexandre [1 ]
van Genderen, Michel Egide [1 ]
Klijn, Eva [1 ]
Bakker, Jan [1 ]
van Bommel, Jasper [1 ]
机构
[1] Erasmus MC Univ Med Ctr, Dept Intens Care Adults, NL-3000 CA Rotterdam, Netherlands
关键词
Near-infrared spectroscopy; Skin temperature; Body surface cooling; Capillary refill time; CRITICALLY-ILL PATIENTS; SKIN BLOOD-FLOW; SUBJECTIVE ASSESSMENT; SKELETAL-MUSCLE; SEVERE SEPSIS; PERFUSION; SHOCK; RESUSCITATION; TEMPERATURE; IDENTIFY;
D O I
10.1007/s00134-012-2486-3
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Near-infrared spectroscopy has been used as a noninvasive monitoring tool for tissue oxygen saturation (StO(2)) in acutely ill patients. This study aimed to investigate whether local vasoconstriction induced by body surface cooling significantly influences thenar StO(2) as measured by InSpectra model 650. Eight healthy individuals (age 26 +/- A 6 years) participated in the study. Using a cooling blanket, we aimed to cool the entire body surface to induce vasoconstriction in the skin without any changes in central temperature. Thenar StO(2) was noninvasively measured during a 3-min vascular occlusion test using InSpectra model 650 with a 15-mm probe. Measurements were analyzed for resting StO(2) values, rate of StO(2) desaturation (RdecStO(2), %/min), and rate of StO(2) recovery (RincStO(2), %/s) before, during, and after skin cooling. Measurements also included heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), capillary refill time (CRT), forearm-to-fingertip skin-temperature gradient (Tskin-diff), perfusion index (PI), and tissue hemoglobin index (THI). In all subjects MAP, CO, SV, and core temperature did not change during the procedure. Skin cooling resulted in a significant decrease in StO(2) from 82% (80-87) to 72% (70-77) (P < 0.05) and in RincStO(2) from 3.0%/s (2.8-3.3) to 1.7%/s (1.1-2.0) (P < 0.05). Similar changes in CRT, Tskin-diff, and PI were also observed: from 2.5 s (2.0-3.0) to 8.5 s (7.2-11.0) (P < 0.05), from 1.0A degrees C (-1.6-1.8) to 3.1A degrees C (1.8-4.3) (P < 0.05), and from 10.0% (9.1-11.7) to 2.5% (2.0-3.8), respectively. The THI values did not change significantly. Peripheral vasoconstriction due to body surface cooling could significantly influence noninvasive measurements of thenar StO(2) using InSpectra model 650 with 15-mm probe spacing.
引用
收藏
页码:606 / 611
页数:6
相关论文
共 18 条
  • [1] Multi-site and multi-depth near-infrared spectroscopy in a model of simulated (central) hypovolemia: lower body negative pressure
    Bartels, Sebastiaan A.
    Bezemer, Rick
    de Vries, Floris J. Wallis
    Milstein, Dan M. J.
    Lima, Alexandre
    Cherpanath, Thomas G. V.
    van den Meiracker, Anton H.
    van Bommel, Jasper
    Heger, Michal
    Karemaker, John M.
    Ince, Can
    [J]. INTENSIVE CARE MEDICINE, 2011, 37 (04) : 671 - 677
  • [2] Skin blood flow affects in vivo near-infrared spectroscopy measurements in human skeletal muscle
    Buono, MJ
    Miller, PW
    Hom, C
    Pozos, RS
    Kolkhorst, FW
    [J]. JAPANESE JOURNAL OF PHYSIOLOGY, 2005, 55 (04) : 241 - 244
  • [3] Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation
    Cohn, Stephen M.
    Nathens, Avery B.
    Moore, Frederick A.
    Rhee, Peter
    Puyana, Juan Carlos
    Moore, Ernest E.
    Beilman, Gregory J.
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2007, 62 (01): : 44 - 54
  • [4] Can near-infrared spectroscopy identify the severity of shock in trauma patients?
    Crookes, BA
    Cohn, SM
    Bloch, S
    Amortegui, J
    Manning, R
    Li, P
    Proctor, MS
    Hallal, A
    Blackbourne, LH
    Benjamin, R
    Soffer, D
    Habib, F
    Schulman, CI
    Duncan, R
    Proctor, KG
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2005, 58 (04): : 806 - +
  • [5] Is muscle StO2 an appropriate variable for investigating early compensatory tissue mechanisms under physiological and pathological conditions?
    De Blasi, R. A.
    [J]. INTENSIVE CARE MEDICINE, 2008, 34 (09) : 1557 - 1559
  • [6] Continuous muscle tissue oxygenation in critically injured patients: A prospective observational study
    Ikossi, Danagra G.
    Knudson, M. Margaret
    Morabito, Diane J.
    Cohen, Mitchell J.
    Wan, Jennifer J.
    Khaw, Linda
    Stewart, Campbell J.
    Hemphill, Claude
    Manley, Geoff T.
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2006, 61 (04): : 780 - 788
  • [7] Start with a subjective assessment of skin temperature to identify hypoperfusion in intensive care unit patients
    Kaplan, LJ
    McPartland, K
    Santora, TA
    Trooskin, SZ
    [J]. JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2001, 50 (04): : 620 - 627
  • [8] The relation of near-infrared spectroscopy with changes in peripheral circulation in critically ill patients
    Lima, Alexandre
    van Bommel, Jasper
    Sikorska, Karolina
    van Genderen, Michel
    Klijn, Eva
    Lesaffre, Emmanuel
    Ince, Can
    Bakker, Jan
    [J]. CRITICAL CARE MEDICINE, 2011, 39 (07) : 1649 - 1654
  • [9] The prognostic value of the subjective assessment of peripheral perfusion in critically ill patients
    Lima, Alexandre
    Jansen, Tim C.
    van Bommel, Jasper
    Ince, Can
    Bakker, Jan
    [J]. CRITICAL CARE MEDICINE, 2009, 37 (03) : 934 - 938
  • [10] Lima AP, 2002, CRIT CARE MED, V30, P1210