Non-invasive monitoring of oxygen delivery in acutely ill patients: new frontiers

Abstract

Hypovolemia, anemia and hypoxemia may cause critical deterioration in the oxygen delivery (DO2). Their early detection followed by a prompt and appropriate intervention is a cornerstone in the care of critically ill patients. And yet, the remedies for these life-threatening conditions, namely fluids, blood and oxygen, have to be carefully titrated as they are all associated with severe side-effects when administered in excess. New technological developments enable us to monitor the components of DO2 in a continuous non-invasive manner via the sensor of the traditional pulse oximeter. The ability to better assess oxygenation, hemoglobin levels and fluid responsiveness continuously and simultaneously may be of great help in managing the DO2. The non-invasive nature of this technology may also extend the benefits of advanced monitoring to wider patient populations.

Minimally Invasive Determinations of Oxygen Delivery and Consumption in Cardiac Surgery: An Observational Study

“…[7][8][9][10] With the introduction of noninvasive CO measurements using echocardiography or CO calculations based on pulse contour analysis, new opportunities exist regarding the perioperative assessment of DO 2 and VO 2 . [11][12][13] In the present study the authors therefore designed a minimally invasive setup for DO 2 and VO 2 measurements, using blood pressure-derived CO measurements (Nexfin device; Edwards Lifesciences, Irvine, CA); point-of-care hemoglobin measurements (HemoCue meter; Radiometer, Copenhagen, Denmark); and arterial saturation (SaO 2 ) and ScvO 2 measurements (with pulse oximetry and central venous catheter-derived blood sampling, respectively). In patients undergoing cardiothoracic surgery, the authors subsequently determined the level of agreement between conventional PAC-based DO 2 and VO 2 measurements with a minimally invasive approach to evaluate whether this less-invasive approach is feasible to implement into daily clinical practice.…”

Systemic Oxygen Delivery during One-Lung Ventilation: Comparison between Propofol and Sevoflurane Anaesthesia in a Randomised Controlled Trial

“…Sevoflurane and propofol, the two most commonly used anaesthetics, have previously been compared in terms of SaO 2 , but not in terms of DO 2 , during OLV [9]. DO 2 reflects the circulation and oxygenation status, and it is increasingly being used in critical care [4]. Our study is the first to measure DO 2 during OLV and to investigate whether DO 2 differs according to the anaesthetic used.…”

“…The concept of systemic delivery of oxygen (DO 2 ) is attracting increasing interest in both the context of anaesthesia [1] and the intensive care unit (ICU) [2,3,4]. DO 2 is calculated as: (haemoglobin × 1.34 × SaO 2 + PaO 2 × 0.003) × cardiac output × 10.…”

Advancement of Sensor Integrated Organ-on-Chip Devices

“…Non-invasive monitoring is important as it allows for undisturbed observation of the subject at hand. Invasive monitoring, especially with oxygen sensing, may disrupt the biological processes being studied, and consequently alter the trajectory of a particular experiment [ 117 , 118 ]. This next study focuses on the non-invasive nature of a 39b-based sensor created by Zirath et al…”