Limb edema in critically ill patients: Comparing intermittent compression and elevation

Ahmadinejad, Mehdi; Razban, Farideh; Jahani, Yunes; Heravi, Faezeh

doi:10.1111/iwj.13704

“…Therefore, the superficial information should be recorded and utilized when analyzing the data in order to account for the effect of variations in adipose tissue 46 , 47 . This is further amplified in these patient populations of interest since it is common in ICU patients to develop edema where the limbs are swollen as water is trapped due to immobilization and other reasons 48 . In such patients, the variation in circumference during ICU stay can provide information about the severity of edema.…”

Section: Discussionmentioning

confidence: 99%

Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care

Yaqub,

Zanoletti,

Cortese

et al. 2024

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The detection of levels of impairment in microvascular oxygen consumption and reactive hyperemia is vital in critical care. However, there are no practical means for a robust and quantitative evaluation. This paper describes a protocol to evaluate these impairments using a hybrid near-infrared diffuse optical device. The device contains modules for near-infrared time-resolved and diffuse correlation spectroscopies and pulse-oximetry. These modules allow the non-invasive, continuous, and real-time measurement of the absolute, microvascular blood/tissue oxygen saturation (StO 2 ) and the blood flow index (BFI) along with the peripheral arterial oxygen saturation (SpO 2 ). This device uses an integrated, computer-controlled tourniquet system to execute a standardized protocol with optical data acquisition from the brachioradialis muscle. The standardized vascular occlusion test (VOT) takes care of the variations in the occlusion duration and pressure reported in the literature, while the automation minimizes inter-operator differences. The protocol we describe focuses on a 3-min occlusion period but the details described in this paper can readily be adapted to other durations and cuff pressures, as well as other muscles. The inclusion of an extended baseline and post-occlusion recovery period measurement allows the quantification of the baseline values for all the parameters and the blood/tissue deoxygenation rate that corresponds to the metabolic rate of oxygen consumption.Once the cuff is released, we characterize the tissue reoxygenation rate, magnitude,

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“…Therefore, the superficial information should be recorded and utilized when analyzing the data in order to account for the effect of variations in adipose tissue 46 , 47 . This is further amplified in these patient populations of interest since it is common in ICU patients to develop edema where the limbs are swollen as water is trapped due to immobilization and other reasons 48 . In such patients, the variation in circumference during ICU stay can provide information about the severity of edema.…”

Section: Discussionmentioning

confidence: 99%

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0

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The detection of levels of impairment in microvascular oxygen consumption and reactive hyperemia is vital in critical care. However, there are no practical means for a robust and quantitative evaluation. This paper describes a protocol to evaluate these impairments using a hybrid near-infrared diffuse optical device. The device contains modules for near-infrared time-resolved and diffuse correlation spectroscopies and pulse-oximetry. These modules allow the non-invasive, continuous, and real-time measurement of the absolute, microvascular blood/tissue oxygen saturation (StO 2 ) and the blood flow index (BFI) along with the peripheral arterial oxygen saturation (SpO 2 ). This device uses an integrated, computer-controlled tourniquet system to execute a standardized protocol with optical data acquisition from the brachioradialis muscle. The standardized vascular occlusion test (VOT) takes care of the variations in the occlusion duration and pressure reported in the literature, while the automation minimizes inter-operator differences. The protocol we describe focuses on a 3-min occlusion period but the details described in this paper can readily be adapted to other durations and cuff pressures, as well as other muscles. The inclusion of an extended baseline and post-occlusion recovery period measurement allows the quantification of the baseline values for all the parameters and the blood/tissue deoxygenation rate that corresponds to the metabolic rate of oxygen consumption.Once the cuff is released, we characterize the tissue reoxygenation rate, magnitude,

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Early Mobilization, Early Ambulation, and Burn Therapy in the Acute Hospital Setting

O’Neil,

Hines,

Wirdzek

et al. 2023

Physical Medicine and Rehabilitation Clinics of North America

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Limb edema in critically ill patients: Comparing intermittent compression and elevation

Cited by 5 publications

References 15 publications

Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care

Non-Invasive Monitoring of Microvascular Oxygenation and Reactive Hyperemia using Hybrid, Near-Infrared Diffuse Optical Spectroscopy for Critical Care

JoVE Video Dataset

Early Mobilization, Early Ambulation, and Burn Therapy in the Acute Hospital Setting

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