• Critical care medicine · Apr 2011

    Comparative Study

    Comparison of four different vascular occlusion tests for assessing reactive hyperemia using near-infrared spectroscopy.

    • Claire Mayeur, Sébastien Campard, Christian Richard, and Jean-Louis Teboul.
    • Service de Réanimation Médicale, Centre Hospitalo-Universitaire de Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris Sud, Le Kremlin-Bicêtre, France.
    • Crit. Care Med. 2011 Apr 1;39(4):695-701.

    ObjectiveTo compare data gathered via four different types of vascular occlusion test (VOT) by using near-infrared spectroscopy. The data may support a standardized method to appropriately measure the postischemic recovery slope, which is currently emphasized as a quantitative marker of the microvascular reserve in septic patients.DesignProspective study.SettingMedical intensive care unit of a university hospital.Patients And MeasurementsIn 20 healthy volunteers and in 20 septic shock patients, we measured muscle tissue oxygen saturation at the thenar eminence by using near-infrared spectroscopy and performed four different vascular occlusion tests in a random order. A pneumatic cuff was placed around either the upper arm (A) or the forearm (FA). Cuff inflation was maintained either during 3 mins (VOT(A3min) and VOT(FA3min)) or until muscle tissue oxygen saturation decreased to 40% (VOT(A40%) and VOT(FA40%)).ResultsIn volunteers: 1) During VOT(A3min) and VOT(FA3min), the minimal muscle tissue oxygen saturation was significantly higher than 40% (52% ± 10% and 54% ± 6%, respectively), and 2) the muscle tissue oxygen saturation recovery slopes were steeper with VOT(A40%) and VOT(FA40%) than with VOT(A3min) and VOT(FA3min), respectively. Considering the pooled data obtained during VOT(A3min) and VOT(FA3min) (n = 40), recovery slope negatively correlated with minimal muscle tissue oxygen saturation in volunteers (r² = .46, p < .0001) as in septic patients (r² = .34, p = .0001). Considering the pooled data obtained during 40% VOTs, the recovery slope did not correlate with ischemic time in either group. The overlap of recovery slopes between volunteers and septic patients was small for both 40% VOTs but large for both 3-min occlusion VOTs.ConclusionThe comparison of recovery slopes between volunteers and septic patients and the fact that the recovery slope was influenced by the extent of muscle tissue oxygen saturation decrease during ischemia and not by the ischemic time both support the use of a fixed minimal muscle tissue oxygen saturation target (40%) over the use of a fixed ischemic time (3 mins) for assessing reactive hyperemia by using near-infrared spectroscopy.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…