Low Tissue Oxygen Saturation Is Associated with Requirements for Transfusion in the Rural Trauma Population

Khasawneh, Mohammad A.; Zielinski, Martin D.; Jenkins, Donald H.; Zietlow, Scott P.; Schiller, Henry J.; Rivera, Mariela

doi:10.1007/s00268-014-2505-3

Cited by 9 publications

(3 citation statements)

References 31 publications

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“…Upon arrival at a trauma center, an initial StO 2 value (measured concurrently with or before vital signs) less than 65% is predictive of hemorrhagic shock, indicating a requirement for early administration of blood. 15 StO 2 can be used as an early predictor of hemorrhage and may be superior to clinical assessments of blood pressure, heart rate, arterial oxygen saturation, urine output, and hemoglobin concentration that may not appear until class III/IV shock has occurred. 15 NIRS technology also has been used by the armed forces during conflicts to detect early states of hypovolemic shock.…”

Section: Tissue Oxygen Monitoring Technologymentioning

confidence: 99%

“…15 StO 2 can be used as an early predictor of hemorrhage and may be superior to clinical assessments of blood pressure, heart rate, arterial oxygen saturation, urine output, and hemoglobin concentration that may not appear until class III/IV shock has occurred. 15 NIRS technology also has been used by the armed forces during conflicts to detect early states of hypovolemic shock. 16 Macdonald and Brown 17 used the MeSH terms near-infrared spectroscopy, sepsis, shock, tissue oxygen saturation, and microcirculation to search for relevant Unlike pulse oximetry, NIRS and StO 2 can be used to measure perfusion in a pulseless or hypothermic patient.…”

Section: Tissue Oxygen Monitoring Technologymentioning

confidence: 99%

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Tissue Oxygenation Monitoring as a Guide for Trauma Resuscitation

Mitchell

2016

Critical Care Nurse

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Hypoperfusion is the most common event preceding the onset of multiple organ dysfunction syndrome during trauma resuscitation. Detecting subtle changes in perfusion is crucial to ensure adequate tissue oxygenation and perfusion. Traditional methods of detecting physiological changes include measurements of blood pressure, heart rate, urine output, serum levels of lactate, mixed venous oxygen saturation, and central venous oxygen saturation. Continuous noninvasive monitoring of tissue oxygen saturation in muscle has the potential to indicate severity of shock, detect occult hypoperfusion, guide resuscitation, and be predictive of the need for interventions to prevent multiple organ dysfunction syndrome. Tissue oxygen saturation is being used in emergency departments, trauma rooms, operating rooms, and emergency medical services. Tissue oxygen saturation technology is just as effective as mixed venous oxygen saturation, central venous oxygen saturation, serum lactate, and Stewart approach with strong ion gap, yet tissue oxygen saturation assessment is also a direct, noninvasive microcirculatory measurement of oxygen saturation. (Critical Care Nurse. 2016;36[3]:12-19,70) This article has been designated for CE contact hour(s). The evaluation tests your knowledge of the following objectives: 1 Insufficient oxygen to meet cellular demands leads to cellular ischemia, bacterial translocation, sepsis, worsening of shock, organ dysfunction, multiple system organ failure, and death.2 A balance must be maintained between oxygen delivery (DO 2 ) and oxygen consumption (VO 2 ) to minimize anaerobic metabolism, maintain normal metabolic processes, and meet the cellular requirements for the body.2 High baseline oxygen-extraction organs, such as the heart, are at high risk for ischemia if the VO 2 just meets the oxygen demand. Adequate physiological oxygen reserves need to be available in order to cope with increases in oxygen demand.

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Section: Tissue Oxygen Monitoring Technologymentioning

confidence: 99%

Section: Tissue Oxygen Monitoring Technologymentioning

confidence: 99%

Tissue Oxygenation Monitoring as a Guide for Trauma Resuscitation

Mitchell

2016

Critical Care Nurse

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“…These results are similar to a recent study in 325 rural trauma patients, where an ED StO 2 less than 65% was associated with greater blood transfusion requirements over the next 24 hours. 79 In a recent case series, StO 2 was obtained on the battlefield at the point of injury. 80 The first StO 2 (and vital signs) were obtained 22 AE 7 minutes after the injury.…”

Section: Near-infrared Spectroscopy-skeletal Tissue Oxygenationmentioning

confidence: 98%