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Comparative Study
. 2009;13 Suppl 5(Suppl 5):S3.
doi: 10.1186/cc8001. Epub 2009 Nov 30.

Characterization of tissue oxygen saturation and the vascular occlusion test: influence of measurement sites, probe sizes and deflation thresholds

Hernando Gómez  1 , Jaume Mesquida, Peter Simon, Hyung Kook Kim, Juan C Puyana, Can Ince, Michael R Pinsky
Affiliations
Comparative Study

Characterization of tissue oxygen saturation and the vascular occlusion test: influence of measurement sites, probe sizes and deflation thresholds

Hernando Gómez et al. Crit Care. 2009.

Abstract

Introduction: Tissue oxygen saturation (StO2) and the vascular occlusion test (VOT) can identify tissue hypoperfusion in trauma and sepsis. However, the technique is neither standardized nor uses the same monitoring site. We hypothesized that baseline and VOT StO2 would be different in the forearm (F) and thenar eminence (TH) and that different minimal StO2 values during the VOT would result in different reoxygenation rates (ReO2).

Methods: StO2 and its change during the VOT were simultaneously measured in the F and TH, with 15 mm and 25 mm probes, using the 325 InSpectra monitor in 18 healthy, adult volunteers. Two VOTs were done to a threshold thenar StO2 of 40% interchanging the 15 mm and 25 mm probes between sites. Two additional VOTs were done to thresholds of 50% and 30%. Baseline StO2 (BaseO2), the deoxygenation rate (DeO2) and ReO2 were compared between sites, probes and (%O2/minute) thresholds. Results are presented as the median (interquartile range), P-value.

Results: BaseO2, DeO2, ReO2, area under the curve and hyperemia duration values were different when comparing TH vs. F and 15 mm vs. 25 mm probes. ReO2 was different between different thresholds for the TH and 15 mm probes. TH15 mm vs. F15 mm: BaseO2, 90.4 (85.2, 93.5) vs. 85.2 (80.7, 90.2), P = 0.031; DO2, -12.1 (-16.2, -11.3) vs. -8.5 (-10.3, -7.8), P = 0.011; ReO2, 297.2 (213.7, 328.6), P < 0.0001; 15 mm vs. 25 mm probe: BaseO2, 97.2 (89.4, 94.7) vs. 87.3 (81.7, 90.9), P = 0.016; DeO2, -18.0 (-24.1, -14.8) vs. -9.9 (-15.3, -6.5), P < 0.0001; and ReO2, 401.6 (331.7, 543.2) vs. 160.5 (132.3, 366.9), P = 0.012, respectively. TH15 mm vs. TH25 mm: BaseO2, P = 0.020; DeO2, P < 0.0001; and ReO2, P < 0.0001. Threshold StO2 values (15 mm probe only): ReO2, P = 0.003; DeO2, P = 0.60. ReO2 at 40% and 50% StO2 thresholds, P = 0.01.

Conclusions: BaseO2, DeO2 and ReO2 were different when measured in different anatomical sites (F and TH) and with different probe sizes, and ReO2 was different with differing VOT release StO2 threshold values. Thus, standardization of the site, probe and VOT challenge need to be stipulated when reporting data.

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Figures

Figure 1
Figure 1
Tissue oxygen saturation (StO2) during a vascular occlusion test. Calculated parameters: deoxygenation rate (DeO2), reoxygenation rate (ReO2), hyperemia area under the curve (AUC), and hyperemia duration.
Figure 2
Figure 2
Box plots comparing tissue oxygen saturation (StO2) parameters measured with the 15 mm probe at different anatomical sites. DeO2, deoxygenation rate; ReO2, reoxygenation rate.
Figure 3
Figure 3
Box plots comparing tissue oxygen saturation (StO2) parameters measured with the 25 mm probe at different anatomical sites. DeO2, deoxygenation rate; ReO2, reoxygenation rate.
Figure 4
Figure 4
Box plots comparing tissue oxygen saturation (StO2) parameters measured on the thenar eminence with different probes. DeO2, deoxygenation rate; ReO2, reoxygenation rate.
Figure 5
Figure 5
Box plots comparing StO2 parameters measured using different deflation thresholds. DeO2, deoxygenation rate; ReO2, reoxygenation rate.
Figure 6
Figure 6
Box plot comparison of the hyperemic response between anatomical sites and probe sizes. AUC, hyperemic area under the curve.
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