Tissue oxygenation index reflects changes in forearm blood flow after brief ischemia

Kinoshita, Hiroyuki; Akahori, Takahiko; Nakamura, Emi; Okawa, Hazuki; Kawahito, Shinji; Kitahata, Hiroshi; Fujiwara, Yoshihiro

doi:10.2152/jmi.64.228

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…We observed a gradual decrease in forearm oxygenation during both PSVT and VT (Fig. 1 ), which indicates a reduction in peripheral tissue blood flow 16 – 19 . Moreover, it was likely caused by vasoconstriction rather than a decrease in perfusion pressure (i.e., MAP; Fig.…”

Section: Discussionmentioning

confidence: 79%

“…The peripheral blood flow response to tachyarrhythmia was estimated by forearm oxygenation measured using near-infrared spectroscopy (NIRS). Among NIRS-derived variables (tissue oxygen index [TOI] and relative concentrations of oxygenated [Oxy-Hb] and deoxygenated [Deoxy-Hb] haemoglobin), TOI and Oxy-Hb in resting skeletal muscles are regarded as indices of regional tissue blood flow responses 16 – 19 . In particular, TOI appears to be more useful than Oxy-Hb for monitoring tissue oxygenation, given its lower sensitivity to changes in skin circulation 20 .…”

Section: Introductionmentioning

confidence: 99%

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Differential relationship between decreased muscle oxygenation and blood pressure recovery during supraventricular and ventricular tachycardia

Ishii,

Machino,

Hatori

et al. 2023

Sci Rep

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Vasoconstriction during tachyarrhythmia contributes to maintenance of arterial pressure (AP) by decreasing peripheral blood flow. This cross-sectional observational study aimed to ascertain whether the relationship between peripheral blood flow and AP recovery occurs during both paroxysmal supraventricular (PSVT, n = 19) and ventricular tachycardias (VT, n = 17). Peripheral blood flow was evaluated using forearm tissue oxygen index (TOI), and mean AP (MAP) was measured using a catheter inserted in the brachial or femoral artery during an electrophysiological study. PSVT and VT rapidly decreased MAP with a comparable heart rate (P = 0.194). MAP recovered to the baseline level at 40 s from PSVT onset, but not VT. The forearm TOI decreased during both tachyarrhythmias (P ≤ 0.029). The TOI response was correlated with MAPrecovery (i.e., MAP recovery from the initial rapid decrease) at 20–60 s from PSVT onset (r = -– 0.652 to – 0.814, P ≤ 0.0298); however, this association was not observed during VT. These findings persisted even after excluding patients who had taken vasoactive drugs. Thus, restricting peripheral blood flow was associated with MAP recovery during PSVT, but not VT. This indicates that AP recovery depends on the type of tachyarrhythmia: different cardiac output and/or vasoconstriction ability during tachyarrhythmia.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Differential relationship between decreased muscle oxygenation and blood pressure recovery during supraventricular and ventricular tachycardia

Ishii,

Machino,

Hatori

et al. 2023

Sci Rep

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“…OI is the ratio of PaO 2 to FiO 2 , which re ects the changes in pulmonary oxygenation function and ventilation function to a certain extent. For patients with a pulmonary ventilation/blood ow imbalance or pulmonary dysfunction, OI decreases (25). A-aDO 2 is an important indicator re ecting lung diffusion function, which can re ect the degree of lung injury.…”

Section: Discussionmentioning

confidence: 99%

Limb remote ischemic preconditioning on lung protection in patients with thoracoscopic lobectomy: a randomized controlled trial

Zhang

Yang

Zhong³

et al. 2023

Preprint

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Background One-lung ventilation (OLV) is often used during lobectomy anesthesia. Inflammation and oxidative stress during OLV can aggravate lung tissue injury, which is an important factor causing postoperative acute lung injury. Studies have confirmed that remote ischemic preconditioning (RIPC) can initiate endogenous protective mechanisms and alleviate injury to target organs. However, whether RIPC has a lung protective effect in patients undergoing lung resection remains unknown. Therefore, this randomized controlled clinical study investigated whether RIPC could reduce OLV-related lung injury, improve intraoperative oxygenation parameters, and induce lung protection in patients with thoracoscopic lobectomy. Methods We adopted a single-center, randomized, single-blind clinical controlled trial method and selected 54 patients who underwent inferior lobectomy with OLV and were randomly divided into a preconditioning group (RIPC group) and a blank control group (NC group). The preconditioning group received lower limb RIPC before OLV, while the blank NC group did not receive RIPC. RIPC was used to perform 5 cycles of 5 min ischemia /5 min reperfusion on the opposite lower limb via a limb ischemia preadaptor. Four time points after anesthesia induction (T0), 30 min after single-lung ventilation (T1), 90 min after single-lung ventilation (T2), and 30 min after double-lung ventilation restoration (T3) were used as the data-recording and blood-collection points. The main outcome measure was the oxygenation index (OI), while the secondary outcome measures included Clara cell secreted protein CC16, inflammatory cytokines (IL-6), serum malondialdehyde (MDA), lung-related variables, and length of hospital stay. Results There was no significant difference in the OI in the RIPC group compared with the NC group at each time point of T0-T3 (P > 0.05), but in general, the OI value of of the RIPC group at the T1-T3 time points showed an increasing trend compared with that of the NC group. There were significant differences in plasma CC16 levels between T1-T3 (P < 0.05), and the plasma CC16 level in the RIPC group was significantly decreased. IL-6 and MDA levels at T1-T3 were lower than those in the NC group (P < 0.05). However, there were no significant differences in blood pH and pulmonary-related variables (respiratory index (RI), alveolar-arterial oxygen partial pressure (A-aDO2), and arterial-alveolar oxygen partial pressure (a/A ratio)) (P > 0.05), and the length of hospital stay was not significantly different (P > 0.05). Conclusions Remote limb ischemic preconditioning can reduce lung injury during lobectomy and can protect lung tissue mainly by reducing the inflammatory and oxidative-stress responses.

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“…4 The subsequent cardiopulmonary resuscitation can lead to ischaemia–reperfusion injury of tissues, 7 which can lead to vascular endothelial cell injury that initiates coagulation reactions and systemic inflammatory reactions. 8 These in turn can result in blood coagulation disorders, microvascular thrombosis, disseminated intravascular coagulation (DIC) and multiple organ failure. 9 These may be the main reasons for the poor results of CPR.…”

Section: Discussionmentioning

confidence: 99%

Anticoagulation therapy could improve the restoration of sinus rhythm and spontaneous circulation in hospital patients with CPR

Wang

Bai

et al. 2019

J Int Med Res

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Objective To analyse the role of anticoagulation therapy in cardiopulmonary resuscitation (CPR) following an in-hospital cardiac arrest. Methods This single-centre retrospective cohort study enrolled patients treated with in-hospital CPR that met the inclusion and exclusion criteria. The patients were divided into a without anticoagulation group and an anticoagulation group. The main outcome measures were the restoration of spontaneous respiration, restoration of sinus rhythm (ROSR), restoration of spontaneous circulation (ROSC) and the hospital mortality. Results The study analysed 344 patients: 272 in the without anticoagulation group and 72 in the anticoagulation group. Multiple logistic regression analyses demonstrated that anticoagulation therapy improved ROSR (adjusted odds ratio [OR] 2.21, 95% confidence interval [CI] 1.23, 3.96) and ROSC (adjusted OR 1.91, 95% CI 1.08, 3.40), but it did not improve the restoration of spontaneous respiration (adjusted OR 1.64, 95% CI 0.72, 3.76) and hospital survival (adjusted OR 0.90, 95% CI 0.40, 1.99). Conclusion Anticoagulation therapy improved ROSR and ROSC, but did not decrease the mortality rate of hospitalized patients undergoing CPR following in-hospital cardiac arrest.

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Tissue oxygenation index reflects changes in forearm blood flow after brief ischemia

Cited by 5 publications

References 9 publications

Differential relationship between decreased muscle oxygenation and blood pressure recovery during supraventricular and ventricular tachycardia

Differential relationship between decreased muscle oxygenation and blood pressure recovery during supraventricular and ventricular tachycardia

Limb remote ischemic preconditioning on lung protection in patients with thoracoscopic lobectomy: a randomized controlled trial

Anticoagulation therapy could improve the restoration of sinus rhythm and spontaneous circulation in hospital patients with CPR

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