The association of near-infrared spectroscopy-derived tissue oxygenation measurements with sepsis syndromes, organ dysfunction and mortality in emergency department patients with sepsis

• DOI: 10.1186/cc10463
• Publication Date: 2011-09-23T10:23:38Z
• Authors: Nathan I Shapiro; Ryan Arnold; Robert Sherwin; Jennifer O'Connor; Gabriel Najarro; Sam Singh; David Lundy; Teresa Nelson; Stephen W Trzeciak; Alan E Jones
• Keywords: SOFA score; Vascular occlusion; Organ dysfunction; Oxygen Saturation

Near-infrared spectroscopy (NIRS) noninvasively measures peripheral tissue oxygen saturation (StO2). NIRS may be utilized along with a vascular occlusion test, in which limb blood flow is temporarily occluded and released, to quantify bed's rate of exchange during ischemia recovery. The objective this study was test the hypothesis that NIRS-derived StO2 (StO2 initial, recovery) identify patients who are shock at increased risk organ dysfunction (Sequential Organ Failure Assessment (SOFA) score ≥ 2 24 hours) dying hospital. This prospective, observational comprised convenience sample three cohorts adult (age > 17 years) urban university emergency departments: (1) septic cohort (systolic pressure < 90 after fluid challenge; "SHOCK" cohort, n = 58), (2) sepsis without (the "SEPSIS" 60) department infection (n 50). We measured recovery slopes for all patients. Outcomes were syndrome severity, (SOFA in-hospital mortality. Among 168 enrolled, mean initial lower SHOCK than SEPSIS (76% vs 81%), an impaired slope (-10.2 5.2%/minute -13.1 4.4%/minute) (2.4 1.6%/second 3.9 1.7%/second) (P 0.001 all). well-correlated SOFA hours (-0.35; P 0.001), promising area under curve (AUC) mortality 0.81. correlation 0.21 0.02), fair AUC 0.70. significantly but less strongly correlated (-0.18; 0.04), poor 0.56. measurements abnormal compared most associated Further validation warranted. NCT01062685