Tissue saturation measurement - exciting prospects, but standardisation and reference data still needed

Jones, N.B.; Terblanche, Marius

doi:10.1186/cc8970

Cited by 12 publications

(5 citation statements)

References 13 publications

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“…These small differences in protocol highlight the need for continued standardization of the VOT among research groups to readily facilitate comparison of results. 13 The authors' results demonstrating no significant difference in the StO 2 measured immediately before each VOT contrasted a previous finding that initiation of CPB causes a significant decrease in StO 2 that corresponded with changes in serum lactate concentration, base deficit, and calculated oxygen delivery. 14 Their results suggested that while measuring the trend of StO 2 may not be a sufficiently sensitive indicator of poor tissue perfusion in all cardiac surgery patients undergoing CPB, the additional interrogation of the microcirculation by VOT may increase the sensitivity of this technology to detect a state of tissue malperfusion before it becomes apparent through clinical findings (eg, oliguria) or biochemical markers (eg, serum lactate).…”

Section: Discussioncontrasting

confidence: 74%

A Novel Assessment of Peripheral Tissue Microcirculatory Vasoreactivity Using Vascular Occlusion Testing During Cardiopulmonary Bypass

Smith

Murkin

2014

Journal of Cardiothoracic and Vascular Anesthesia

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Section: Discussioncontrasting

confidence: 74%

A Novel Assessment of Peripheral Tissue Microcirculatory Vasoreactivity Using Vascular Occlusion Testing During Cardiopulmonary Bypass

Smith

Murkin

2014

Journal of Cardiothoracic and Vascular Anesthesia

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“…Equally, dynamic changes in S t O 2 during a vascular occlusion test have been proposed as a way to improve the discrimination of patients with and without microcirculatory insufficiency [10]. However, reference data on how to conduct and interpret the occlusion test have not been standardised [16, 17].…”

mentioning

confidence: 99%

Effect of hyperoxia and vascular occlusion on tissue oxygenation measured by near infra‐red spectroscopy (InSpectra™): a volunteer study

Kyle

Litton

2012

Anaesthesia

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Summary Standard cardiorespiratory monitoring may fail to detect occult tissue ischaemia. This study assessed whether a near infra‐red spectroscopy tissue oxygen saturation monitor (InSpectra™) could detect progressive peripheral tissue ischaemia and whether hyperoxia may confound tissue oxygen saturation measurement. Tissue oxygen and arterial oxygen saturations were measured continuously in 30 healthy volunteers, first during a period of progressive increase in inspired oxygen concentration and subsequently during two periods of low‐ and high‐pressure limb ischaemia. Increasing inspired oxygen concentration was associated with a small increase in mean (SD) tissue oxygen saturation of 5.3 (7.1) %, reaching a plateau between 30% and 40% inspired oxygen. The rate and magnitude of decreases in tissue oxygen saturations were greater during high‐ than low‐pressure ischaemia with a mean (SD) desaturation rate of 3.3 (0.9) vs 1.8 (0.8) %.min−1 (p < 0.01). The dose‐related association and lack of confounding by hyperoxia suggest that tissue oxygen saturation monitoring may be a useful adjunct to detect occult ischaemia.

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“…Sepsis and shock result in disturbances in microcirculatory perfusion and a change in tissue oxygen utilization that may not be reflected in arterial sO 2 levels. According to many authorities, tissue oxygenation is a better marker of the underlying pathological processes as well as responsiveness to some treatments [ 15 , 16 ]. Tissue oxygen levels are more important, because the arterial O 2 content and an adequate bulk transport of oxygen by the cardiovascular system may not guarantee delivery of oxygen to the critical tissues of the body [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Validation of a Novel Noninvasive Technology to Estimate Blood Oxygen Saturation Using Green Light: Observational Study

Gokhale,

Daggubati,

Alexandrakis

2024

JMIR Biomed Eng

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Background Pulse oximeters work within the red-infrared wavelengths. Therefore, these oximeters produce erratic results in dark-skinned subjects and in subjects with cold extremities. Pulse oximetry is routinely performed in patients with fever; however, an elevation in body temperature decreases the affinity of hemoglobin for oxygen, causing a drop in oxygen saturation or oxyhemoglobin concentrations. Objective We aimed to determine whether our new investigational device, the Shani device or SH1 (US Patent 11191460), detects a drop in oxygen saturation or a decrease in oxyhemoglobin concentrations. Methods An observational study (phase 1) was performed in two separate groups to validate measurements of hemoglobin and oxygen concentrations, including 39 participants recruited among current university students and staff aged 20-40 years. All volunteers completed baseline readings using the SH1 device and the commercially available Food and Drug Administration–approved pulse oximeter Masimo. SH1 uses two light-emitting diodes in which the emitted wavelengths match with absorption peaks of oxyhemoglobin (hemoglobin combined with oxygen) and deoxyhemoglobin (hemoglobin without oxygen or reduced hemoglobin). Total hemoglobin was calculated as the sum of oxyhemoglobin and deoxyhemoglobin. Subsequently, 16 subjects completed the “heat jacket study” and the others completed the “blood donation study.” Masimo was consistently used on the finger for comparison. The melanin level was accounted for using the von Luschan skin color scale (VLS) and a specifically designed algorithm. We here focus on the results of the heat jacket study, in which the subject wore a double-layered heated jacket and pair of trousers including a network of polythene tubules along with an inlet and outlet. Warm water was circulated to increase the body temperature by 0.5-0.8 °C above the baseline body temperature. We expected a slight drop in oxyhemoglobin concentrations in the heating phase at the tissue level. Results The mean age of the participants was 24.1 (SD 0.8) years. The skin tone varied from 12 to 36 on the VLS, representing a uniform distribution with one-third of the participants having fair skin, brown skin, and dark skin, respectively. Using a specific algorithm and software, the reflection ratio for oxyhemoglobin was displayed on the screen of the device along with direct hemoglobin values. The SH1 device picked up more minor changes in oxyhemoglobin levels after a change in body temperature compared to the pulse oximeter, with a maximum drop in oxyhemoglobin concentration detected of 6.5% and 2.54%, respectively. Conclusions Our new investigational device SH1 measures oxygen saturation at the tissue level by reflectance spectroscopy using green wavelengths. This device fared well regardless of skin color. This device can thus eliminate racial disparity in these key biomarker assessments. Moreover, since the light is shone on the wrist, SH1 can be readily miniaturized into a wearable device.

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Tissue saturation measurement - exciting prospects, but standardisation and reference data still needed

Cited by 12 publications

References 13 publications

A Novel Assessment of Peripheral Tissue Microcirculatory Vasoreactivity Using Vascular Occlusion Testing During Cardiopulmonary Bypass

A Novel Assessment of Peripheral Tissue Microcirculatory Vasoreactivity Using Vascular Occlusion Testing During Cardiopulmonary Bypass

Effect of hyperoxia and vascular occlusion on tissue oxygenation measured by near infra‐red spectroscopy (InSpectra™): a volunteer study

Validation of a Novel Noninvasive Technology to Estimate Blood Oxygen Saturation Using Green Light: Observational Study

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