Prognostic value of brachioradialis muscle oxygen saturation index and vascular occlusion test in septic shock patients

Marín‐Corral, Judith; Claverías, Laura; Bodí, M.; Pascual, Sergi; Dubin, Arnaldo; Gea, Joaquim; Rodríguez, Alejandro

doi:10.1016/j.medin.2015.07.002

Cited by 9 publications

(26 citation statements)

References 37 publications

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“…Only 2 of 18 studies were multicenter studies, 14-17 and 2 did not report the number of centers. 18,19 Thirteen studies were conducted in Europe, [17][18][19][20][21][22][23][24][25][26][27][28][29] 1 in Middle-East, 30 3 in North America, [14][15][16]31,32 and 1 in Australia. 33 Follow-up duration ranged from ICU stay to 3 months.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Timing and duration of NIRS monitoring, recorded parameters, and method of VOT varied from study to study. Three studies used central (frontal) NIRS monitoring 30,32,33 and 15 used peripheral monitoring (12 thenar, [14][15][16][17][18][19][21][22][23]25,26,28,29,31 2 brachial, 24,27 and 1 thenar and knee 20 ). InSpectra (Hutchinson Technology, Inc, Minnesota) NIRS device was used in 13 studies, 14 studies, 24,27,30 and Fore-Sight (CAS Medical Systems, Inc., Conneticut) in 2 studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Three studies used central (frontal) NIRS monitoring 30,32,33 and 15 used peripheral monitoring (12 thenar, [14][15][16][17][18][19][21][22][23]25,26,28,29,31 2 brachial, 24,27 and 1 thenar and knee 20 ). InSpectra (Hutchinson Technology, Inc, Minnesota) NIRS device was used in 13 studies, 14 studies, 24,27,30 and Fore-Sight (CAS Medical Systems, Inc., Conneticut) in 2 studies. 32,33 All but 3 studies [14][15][16][17][18][19][21][22][23][24][25][26][27][28][29]31,32 used a single NIRS sensor per patient.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…InSpectra (Hutchinson Technology, Inc, Minnesota) NIRS device was used in 13 studies, 14 studies, 24,27,30 and Fore-Sight (CAS Medical Systems, Inc., Conneticut) in 2 studies. 32,33 All but 3 studies [14][15][16][17][18][19][21][22][23][24][25][26][27][28][29]31,32 used a single NIRS sensor per patient. One study used simultaneous measurements from thenar and knee.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Near-Infrared Spectroscopy in Adult Circulatory Shock: A Systematic Review

Varis

Pettilä

2020

J Intensive Care Med

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Background: Circulatory shock affects every third patient in intensive care units and is associated with high mortality. Near-infrared spectroscopy (NIRS) could serve as a means for monitoring tissue perfusion in circulatory shock. Purpose: To assess the evidence of NIRS monitoring in circulatory shock, we conducted a systematic review of the literature. Methods: The study protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO). We searched PubMed, Ovid MEDLINE, Scopus, and EBM Reviews databases. The reference lists of included articles, last volumes of key journals, and NIRS monitor manufacturers’ webpages were searched manually. Two reviewers independently selected included studies. The quality of studies was assessed. The qualitative synthesis was guided by 3 questions: First, does NIRS monitoring improve patient-centered outcomes in adult circulatory shock patient? Second, do NIRS-derived parameters predict patient-centered outcomes, such as mortality and organ dysfunction, and third, does NIRS monitoring give additional information to guide treatment decisions? Main Results: Eighteen observational studies with 927 patients were included. Because of considerable clinical heterogeneity of the data, we were not able to perform a meta-analysis. Also, due to lack of randomized controlled trials, the first review question could not be answered. Based on the current review, baseline tissue oxygen saturation (StO2) however seems to predict mortality and identify patients with most severe forms of circulatory shock. Conclusions: Near-infrared spectroscopy-derived StO2 can predict mortality in circulatory shock, but high-quality data on the impact of NIRS monitoring are lacking. Furthermore, the marked heterogeneity of the studies makes combining the results of individual studies difficult. Standardization of methodology and clinical randomized trials are needed before wider clinical use.

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Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Near-Infrared Spectroscopy in Adult Circulatory Shock: A Systematic Review

Varis

Pettilä

2020

J Intensive Care Med

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“…24,28 The NIRS device, placed at the forearm, noninvasively, monitored changes in muscle oxygenation, by measuring micromolar (µmol/L) relative changes from baseline for oxygenated, deoxygenated, and total hemoglobin. 29,30 NIRS also assessed the tissue saturation index (TSI), as an absolute parameter for muscle oxygenation. Muscle microvascular function was assessed during reactive hyperemia, as previously described.…”

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confidence: 99%

Impaired Muscle Oxygenation and Elevated Exercise Blood Pressure in Hypertensive Patients

et al. 2017

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E ssential hypertension is characterized by sustained elevations of blood pressure (BP) that can lead to target organ damage and an increased risk for cardiovascular disease. 1Potential life-threatening outcomes of hypertension, such as stroke, renal insufficiency, and cardiac hypertrophy, had been initially perceived as a result of macrovascular alterations. These macrovascular events, however, do not occur independently of microvascular derangement. [2][3][4] Studies have shown that alterations in microvascular structure (rarefaction), vasomotor tonus (enhanced vasoconstriction or blunted vasodilation), and endothelial dysfunction are principal processes in the pathogenesis of hypertension and are evident in several organs/tissue types. [5][6][7][8] In the skeletal muscle, microvascularization is important for oxygen and nutrient supply and for effective metabolite clearance. Studies in hypertension have shown structural or functional impairments in the microvasculature within skeletal muscles, 8 implying a reduced capacity for oxygen delivery and exchange. Furthermore, animal studies using experimental models of hypertension suggested that mitochondrial dysfunction (ie, decreased expression of mitochondrial components and defects in respiratory complexes) and increased oxidative stress result in impaired oxidative capacity and reduced mitochondrial ATP production.9,10 Importantly, in these animals, the mitochondrial dysfunction and the reduced oxidative capacity were present before the development of hypertension, suggesting a possible role of these processes to the pathogenesis of hypertension.11 However, information on skeletal muscle microvascular alterations and oxidative Abstract-This study examined in vivo (1) skeletal muscle oxygenation and microvascular function, at rest and during handgrip exercise, and (2) their association with macrovascular function and exercise blood pressure (BP), in newly diagnosed, never-treated patients with hypertension and normotensive individuals. Ninety-one individuals (51 hypertensives and 40 normotensives) underwent office and 24-hour ambulatory BP, arterial stiffness, and central aortic BP assessment, followed by a 5-minute arterial occlusion and a 3-minute submaximal handgrip exercise. Changes in muscle oxygenated and deoxygenated hemoglobin and tissue oxygen saturation were continuously monitored by nearinfrared spectroscopy and beat-by-beat BP by Finapres. Hypertensives had higher (P<0.001) central aortic BP and pulse wave velocity versus normotensives and exhibited (1) a blunted tissue oxygen saturation response during occlusion, with slower (P=0.006) deoxygenation rate, suggesting reduced muscle oxidative capacity, and (2) a slower reoxygenation rate and blunted hyperemic response (P<0.05), showing reduced microvascular reactivity. Muscle oxygenation responses were correlated with aortic systolic and pulse pressure and augmentation index (P<0.05; age and body mass index (BMI) adjusted). When exercising at the same submaximal intensity, hypertensives required a sig...

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Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors

et al. 2016

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Aims/hypothesis Gestational diabetes mellitus (GDM) is a risk factor for the development of endothelial dysfunction and cardiovascular disease. However, in vivo microvascular endothelial function in GDM has not been investigated. This study aimed to examine, using near-infrared spectroscopy (NIRS), whether: (1) there are differences in microvascular reactivity and skeletal muscle oxygen consumption (mVat rest and during exercise between GDM and uncomplicated pregnancies; and (2) ) and blunted hyperaemia (ΔTSI 6.8 ± 2.9 vs 9.5 ± 3.4) compared with controls (p < 0.01). Despite similar handgrip strength in the GDM and control groups (29.1 ± 8.1 vs 26.2 ± 10.4 kg, respectively), during repeated forearm contractions, women with GDM presented a blunted TSI response (6.5 ± 3.9 vs 19.2 ± 10.9; p < 0.01) and a reduced capacity to maintain the predetermined handgrip (23.4 ± 2.9 vs 27.4 ± 3.8%, p < 0.05). NIRS indices correlated with PWV, 24 h BP and blood glucose concentration earlier in pregnancy (r = 0.40-0.60; p < 0.05). Conclusions/interpretation Women with GDM exhibited a characteristic blunted TSI curve, showing alterations in muscle oxygenation and microvascular responsiveness compared with women with uncomplicated pregnancies. These alterations were manifested during exercise and possibly contribute to the reduced exercise tolerance in GDM. NIRS indices correlated with macrovascular indices (arterial stiffness) and 24 h BP.

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Prognostic value of brachioradialis muscle oxygen saturation index and vascular occlusion test in septic shock patients

Cited by 9 publications

References 37 publications

Near-Infrared Spectroscopy in Adult Circulatory Shock: A Systematic Review

Near-Infrared Spectroscopy in Adult Circulatory Shock: A Systematic Review

Impaired Muscle Oxygenation and Elevated Exercise Blood Pressure in Hypertensive Patients

Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors

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