Abstract
Objective
To determine the relationship between tissue oxygen saturation (StO2) and oxygen delivery (
) during hypoxemia and hyperoxemia.
Study design
Prospective, randomized study.
Animals
Eight purpose-bred Beagle dogs.
Methods
Dogs were anesthetized with isoflurane, ventilated to eucapnia, and instrumented for
thermodilution cardiac output, invasive mean arterial pressure (MAP), sartorius muscle
StO2 and airway gas monitoring. Dogs were administered rocuronium to facilitate mechanical
ventilation and esmolol to minimize anesthetic effects on cardiac output. Instrumentation
and baseline data collection were at 0.21 fractional inspired oxygen (FIO2). Dogs were evaluated at high (0.40 then 0.95) and low (0.15 then 0.10) FIO2 sequences in random order with a 60 minute rest period at FIO2 0.21 between sequences. Target FIO2 was achieved by manipulating nitrogen and oxygen flow rates. Data collected at each
FIO2, after a 10 minute period of stabilization, included heart rate (HR), MAP, cardiac
index (CI) and StO2. Arterial oxygen content (CaO2) and oxygen delivery index (
) were calculated at each FIO2. Data analysis included Pearson’s correlation analysis and mixed-model anova (p < 0.05).
Results
There were no significant differences in HR, MAP or CI across all FIO2 values. Significant decreases occurred in mean ± standard deviation StO2 (90 ± 4% to 69 ± 18%; p = 0.0001),
(458 ± 70 to 281 ± 100 mL minute−1 m−2; p = 0.0008) and CaO2 (13.2 ± 1.53 to 8.4 ± 2.05 mL dL−1; p = 0.0001) from FIO2 0.21 to 0.10, but not at remaining FIO2 values. The correlation between StO2 and
across all FIO2 values was strong (r = 0.97; p = 0.0013) and linear.
Conclusions and clinical relevance
In this model of hypoxemia and hyperoxemia, the strong correlation between StO2 and
suggests that StO2 can be used to estimate
.
Keywords
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References
- Continuous monitoring of mixed venous oxygen saturation in critically ill patients.Anesth Analg. 1982; 61: 513-517
- Near-infrared spectroscopy measurement of regional tissue oxyhemoglobin saturation during hemorrhagic shock.Shock. 1999; 12: 196-1200
- Near-infrared and nuclear magnetic resonance spectroscopic assessment of tissue energetics in an isolated, perfused canine hind limb model of dysoxia.Shock. 2001; 15: 392-397
- Intraoperative hypotension and patient outcome: does “one size fit all?”.Anesthesiology. 2013; 119: 495-497
- Low oxygen delivery produced by anemia, hypoxia, and low cardiac output.J Surg Res. 1991; 51: 425-433
- Oxygen transport in cardiogenic and septic shock.Crit Care Med. 1991; 19: 658-663
- Complications associated with pulmonary artery catheters: a comprehensive clinical review.Scand J Surg. 2009; 98: 199-208
- Measurement of tissue oxygen saturation levels using portable near-infrared spectroscopy in clinically healthy dogs.J Vet Emerg Crit Care. 2008; 18: 594-600
- Reference cardiopulmonary values in normal dogs.Comp Med. 2005; 55: 156-161
- NIRS and the InSpectra StO2 oxygenation monitor.http://www.htibiomeasurement.com(Accessed 24 December 2014.)Date: 2014
- Mixed venous oxygen tension and hyperlactemia. Survival in severe cardiopulmonary disease.JAMA. 1976; 236: 570-574
- Microvascular perfusion is impaired in a rat model of normotensive sepsis.J Clin Invest. 1994; 94: 2077-2083
- Comparison of two different generations of ‘NIRS’ devices and transducers in healthy volunteers and ICU patients.J Clin Monit Comput. 2013; 27: 71-79
- Validation of near-infrared spectroscopy in humans.J Appl Physiol. 1994; 77: 2740-2747
- Tissue hemoglobin O2 saturation during resuscitation of traumatic shock monitored using near infrared spectroscopy.J Trauma. 2000; 48: 637-642
- Near-infrared spectroscopy in patients with severe sepsis: correlation with invasive hemodynamic measurements.Surg Infect. 2008; 9: 515-519
- Noninvasive method for measuring local hemoglobin oxygen saturation in tissue using wide gap second derivative near-infrared spectroscopy.J Biomed Opt. 2005; 10: 034017
- Evaluation of tissue oxygen saturation with near-infrared spectroscopy during experimental acute hemorrhagic shock and resuscitation in dogs.Am J Vet Res. 2014; 75: 48-53
- Skeletal muscle oxygen saturation does not estimate mixed venous oxygen saturation in patients with severe left heart failure and additional severe sepsis or septic shock.Crit Care. 2007; 11: R6
- Tissue-oxygenation assessment using near-infrared spectroscopy during severe sepsis: confounding effects of tissue edema on StO2 values.Intensive Care Med. 2006; 32: 788-789
- Cardiac output monitoring: is there a gold standard and how do the newer technologies compare?.Semin Cardiothorac Vasc Anesth. 2010; 14: 274-282
- The correlation of near-infrared spectroscopy with changes in oxygen delivery in a controlled model of altered perfusion.Am Surg. 2007; 73: 1017-1022
- Early goal-directed therapy in the treatment of severe sepsis and septic shock.N Engl J Med. 2001; 345: 1368-1377
- The association of near-infrared spectroscopy-derived tissue oxygenation measurements with sepsis syndromes, organ dysfunction and mortality in emergency department patients with sepsis.Crit Care. 2011; 15: R223
- Comparison of tissue oxygen saturation in ovariohysterectomized dogs recovering on room air versus nasal oxygen insufflation.J Vet Emerg Crit Care. 2011; 21: 633-638
- Clinicians’ abilities to estimate cardiac index in ventilated children and infants.Arch Dis Child. 1997; 77: 516-518
- Reliability of near-infrared spectroscopy in people with dark skin pigmentation.J Clin Monit Comput. 2005; 19: 195-199
- Red blood cell transfusions and tissue oxygenation in anemic hematology outpatients.Transfusion. 2012; 52: 641-646
Article info
Publication history
Accepted:
October 22,
2014
Received:
March 23,
2014
Identification
Copyright
© 2016 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
