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Muscle perfusion and oxygen consumption by near-infrared spectroscopy in septic-shock and non-septic-shock patients

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Abstract

Objective

To measure muscle blood flow (Qtis) and oxygen consumption (VO2tis) in septic and non-septic critically ill patients by near-infrared spectroscopy (NIRS).

Setting

Surgical intensive care unit of a university hospital.

Patients and participants

Four patients with septic shock, eight post-surgical critically ill patients and ten healthy volunteers.

Measurements and results

Oxyhaemoglobin (HbO2) and deoxyhaemoglobin (HbH) variations after venous occlusion were measured by NIRS in the brachioradialis muscle. We calculated Qtis by the rate of HbO2 and HbH increase in the first 30 s of venous occlusion divided by haemoglobin blood concentration. VO2tis was calculated by subtraction of the arterial HbH from the initial increase of HbH after venous occlusion extrapolated to 1 min. Tissue oxygenation index [TOI = HbO2/(HbO2+HbH)] was also measured before venous occlusion. Two measurements in patients with septic shock, and one measurement in non-septic-shock patients and healthy subjects, were obtained. Of the measurements, 35% were repeated because of low-quality NIRS signal. VO2tis and Qtis were two times larger (P<0.05) in patients with septic shock than in patients without and in healthy subjects. The TOI was very similar among the three groups.

Conclusion

In septic-shock patients the increase in VO2tis was associated with an equivalent increase in Qtis. Therefore, tissue O2 supply does not seem to be a limiting factor for muscle O2 consumption. NIRS combined with venous occlusion allows a rapid, non-invasive and simultaneous assessment of regional perfusion and oxygen consumption. In case of microcirculatory shunt occurrence, the TOI should be cautiously used to assess tissue oxygenation state.

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Acknowledgments

We really thank Dott. C. Robino, Hamamatsu Italia and Dott. Tiziano Binzoni, Department de Physiologie, Centre Medicale Universitarie, Geneva, Switzerland.

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Authors and Affiliations

  1. Servizio di Anestesia e Rianimazione 1, Policlinico di Modena, L.go del Pozzo 71, 41100, Modena, Italy

    Massimo Girardis

  2. Cattedra di Anestesiologia e Rianimazione, Università degli Studi di Modena e Reggio Emilia, Modena, Italy

    Laura Rinaldi, Stefano Busani & Alberto Pasetto

  3. Cattedra di Anestesiologia e Rianimazione, Università degli Studi di Udine, Udine, Italy

    Ivana Flore & Stefano Mauro

Authors
  1. Massimo Girardis
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  2. Laura Rinaldi
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  3. Stefano Busani
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  4. Ivana Flore
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  5. Stefano Mauro
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  6. Alberto Pasetto
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Corresponding author

Correspondence to Massimo Girardis.

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Girardis, M., Rinaldi, L., Busani, S. et al. Muscle perfusion and oxygen consumption by near-infrared spectroscopy in septic-shock and non-septic-shock patients. Intensive Care Med 29, 1173–1176 (2003). https://doi.org/10.1007/s00134-003-1805-0

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  • DOI: https://doi.org/10.1007/s00134-003-1805-0

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