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

被引:30
|
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
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