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Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation.
J Trauma. 2007 Jan; 62(1):44-54; discussion 54-5.JT

Abstract

BACKGROUND

Near-infrared spectroscopy (NIRS) can continuously and noninvasively monitor tissue oxygen saturation (StO2) in muscle and may be an indicator of shock severity. Our purpose was to evaluate how well StO2 predicted outcome in high-risk torso trauma patients presenting in shock.

METHODS

The primary outcome in this prospective study was multiple organ dysfunction syndrome (MODS). StO2 data were obtained upon hospital arrival and for 24 hours along with other known predictors of hypoperfusion and clinical outcomes. Clinicians were blinded to StO2 measurements.

RESULTS

Seven Level I trauma centers enrolled 383 patients, 50 of whom developed MODS. Minimum StO2 performed similarly to maximum base deficit (BD) in discrimination of MODS patients. The sensitivity for both measures (StO2 cutoff = 75%; BD cutoff = 6 mEq/L) was 78%, the specificity was 34% to 39%, the positive predictive value was 18% to 20% and the negative predictive value was 88% to 91%. StO2 and BD were also comparable in predicting death.

CONCLUSIONS

NIRS-derived muscle StO2 measurements perform similarly to BD in identifying poor perfusion and predicting the development of MODS or death after severe torso trauma, yet have the additional advantages of being continuous and noninvasive.

Authors+Show Affiliations

Department of Surgery, University of Texas Health Science Center, San Antonio, Texas 78229, USA. cohn@uthscsa.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17215732

Citation

Cohn, Stephen M., et al. "Tissue Oxygen Saturation Predicts the Development of Organ Dysfunction During Traumatic Shock Resuscitation." The Journal of Trauma, vol. 62, no. 1, 2007, pp. 44-54; discussion 54-5.
Cohn SM, Nathens AB, Moore FA, et al. Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation. J Trauma. 2007;62(1):44-54; discussion 54-5.
Cohn, S. M., Nathens, A. B., Moore, F. A., Rhee, P., Puyana, J. C., Moore, E. E., & Beilman, G. J. (2007). Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation. The Journal of Trauma, 62(1), 44-54; discussion 54-5.
Cohn SM, et al. Tissue Oxygen Saturation Predicts the Development of Organ Dysfunction During Traumatic Shock Resuscitation. J Trauma. 2007;62(1):44-54; discussion 54-5. PubMed PMID: 17215732.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation. AU - Cohn,Stephen M, AU - Nathens,Avery B, AU - Moore,Frederick A, AU - Rhee,Peter, AU - Puyana,Juan Carlos, AU - Moore,Ernest E, AU - Beilman,Gregory J, AU - ,, PY - 2007/1/12/pubmed PY - 2007/2/9/medline PY - 2007/1/12/entrez SP - 44-54; discussion 54-5 JF - The Journal of trauma JO - J Trauma VL - 62 IS - 1 N2 - BACKGROUND: Near-infrared spectroscopy (NIRS) can continuously and noninvasively monitor tissue oxygen saturation (StO2) in muscle and may be an indicator of shock severity. Our purpose was to evaluate how well StO2 predicted outcome in high-risk torso trauma patients presenting in shock. METHODS: The primary outcome in this prospective study was multiple organ dysfunction syndrome (MODS). StO2 data were obtained upon hospital arrival and for 24 hours along with other known predictors of hypoperfusion and clinical outcomes. Clinicians were blinded to StO2 measurements. RESULTS: Seven Level I trauma centers enrolled 383 patients, 50 of whom developed MODS. Minimum StO2 performed similarly to maximum base deficit (BD) in discrimination of MODS patients. The sensitivity for both measures (StO2 cutoff = 75%; BD cutoff = 6 mEq/L) was 78%, the specificity was 34% to 39%, the positive predictive value was 18% to 20% and the negative predictive value was 88% to 91%. StO2 and BD were also comparable in predicting death. CONCLUSIONS: NIRS-derived muscle StO2 measurements perform similarly to BD in identifying poor perfusion and predicting the development of MODS or death after severe torso trauma, yet have the additional advantages of being continuous and noninvasive. SN - 0022-5282 UR - https://www.unboundmedicine.com/medline/citation/17215732/Tissue_oxygen_saturation_predicts_the_development_of_organ_dysfunction_during_traumatic_shock_resuscitation_ L2 - https://doi.org/10.1097/TA.0b013e31802eb817 DB - PRIME DP - Unbound Medicine ER -