Tongue oximetry in children with extensive thermal injury: comparison with peripheral oximetry

Coté, Charles J.; Daniels, Alfred L.; Connolly, Michelle; Szyfelbein, S.K.; Wickens, Charles D.

doi:10.1007/bf03008709

Cited by 25 publications

(9 citation statements)

References 11 publications

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“…In this situation, the clinician has to rely on intermittent arterial blood samples and a blood gas analyser or a CO-oximeter which is not always ideal. A pulse oximeter probe attached to the tongue has been used with some success in children with extensive burns [13], however, for 25% of the time in that study, the tongue oximeter failed to register saturation values. To overcome these problems, we have used a reflectance photoplethysmographic probe in the oesophagus which gives continuous oxygen saturation readings.…”

Section: Discussionmentioning

confidence: 91%

Evaluation of oesophageal reflectance pulse oximetry in major burns patients

Pal

Kyriacou

Kumaran

et al. 2005

Burns

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Pulse oximetry is being used in everyday clinical practice in anaesthesia utilising a peripheral probe. However, it may be unreliable in certain clinical situations such as hypothermia, hypovolemia, vasoconstriction and decreased cardiac output. Similar situations occur in burns patients and, more importantly, burns to extremities which limit the sites available for measurement of peripheral oxygen saturation (SpO(2)). To overcome these limitations, the oesophagus has been investigated as an alternative measurement site, as perfusion may be preferentially preserved centrally. A miniaturised reflectance oesophageal saturation (SpO(2)) probe has been constructed utilising infrared and red photodiodes and a photodetector. Our study was aimed at evaluating the reliability of oesophageal pulse oximetry in major burns patients. Seven adult patients (five males, two females) were studied. They were sedated and ventilated as part of their routine care. Measurable photoplethysmographic (PPG) traces and SpO(2) values were obtained in the oesophagus of all patients at a mean depth of 15.6+/-1.8 cm (measured from the lips). It was found that the oesophageal pulse oximeter results were in good agreement with oxygen saturation measurements obtained by a CO-oximeter. The mean (+/-S.D.) of the differences between the oesophageal oxygen saturation results and those from CO-oximetry was 0.50+/-0.69%. A Bland and Altman analysis showed that the bias and the limits of agreement between the oesophageal and commercial toe pulse oximeters were 0.4% and -3.6% to 4.6%, respectively. This study suggests that the oesophagus can be used as an alternative site for monitoring arterial blood oxygen saturation by pulse oximetry in burned patients.

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Section: Discussionmentioning

confidence: 91%

Evaluation of oesophageal reflectance pulse oximetry in major burns patients

Pal

Kyriacou

Kumaran

et al. 2005

Burns

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“…A pulse oximeter probe attached to the tongue has been used with some success in children with extensive burns [6] however, for 25% of the time in that study the tongue oximeter failed to register saturation values. To overcome these problems we have used a reflectance photoplethysmographic probe in the esophagus which gives continuous oxygen saturation readings.…”

Section: Discussionmentioning

confidence: 99%

Esophageal SpO<inf>2</inf> measurements from a pediatric burns-patient: A case study

Kyriacou

May

Petros³

2013

2013 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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“…With exception, 22 the few (case-) reports published are restricted to the pediatric population. [23][24][25] Moreover, while in those cases lingual pulseoximetry is merely using the alternative location to assess systemic SpO 2 , our approach to assess arterial pulsatility and SpO 2 to check the viability of the "organ tongue" has not been reported before.…”

Section: Discussionmentioning

confidence: 99%

Thinking Out-of-the-Box: A Non-Standard Application of Standard Pulse-Oximetry and Standard Near-Infrared Spectroscopy in a COVID-19 Patient

Schober

Lust

Heunks

et al. 2020

J Intensive Care Med

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Purpose: Purpose of this report is to describe the feasibility of lingual pulse oximetry and lingual near-infrared spectroscopy (NIRS) in a COVID-19 patient to assess lingual tissue viability after several days of mechanical ventilation in the prone position. Materials & Methods: In a COVID-19 ICU-patient, the tongue became grotesquely swollen, hardened and protruding from the oral cavity after 20 h of mechanical ventilation uninterrupted in the prone position. To assess the doubtful viability of the tongue, pulse-oximetric hemoglobin O2-saturation (SpO2; Nellcor, OxiMax MAX-NI, Covidien, MA, USA) and NIRS-based, regional tissue O2-saturation measurements (rSO2; SenSmart, Nonin, MN, USA) were performed at the tongue. Results: At the tongue, regular pulse-oximetric waveforms with a pulse-oximetric hemoglobin O2-saturation (SpO2) of 88% were recorded, i.e. only slightly lower than the SpO2 reading at the extremities at that time (90%). Lingual NIRS-based rSO2 measurements yielded stable tissue rSO2-values of 76-78%, i.e. values expected also in other adequately perfused and oxygenated (muscle-) tissues. Conclusion: Despite the alarming, clinical finding of a grotesquely swollen, rubber-hard tongue and clinical concerns on the adequacy of the tongue perfusion and oxygenation, our measurements of both arterial pulsatility (SpO2) and NIRS-based tissue oxygenation (rSO2) suggested adequate perfusion and oxygenation of the tongue, rendering non-vitality of the tongue, e.g. by lingual venous thrombosis, unlikely. To our knowledge, this is the first clinical report of lingual rSO2 measurement.

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Tongue oximetry in children with extensive thermal injury: comparison with peripheral oximetry

Abstract: We undertook a prospective study of standard peripheral pulse oximetry versus a modified pulse oximeter probe applied to the tongue in order to determine the efficacy of this alternative monitoring site in children with thermal injuries. Ten patients with a mean age ( +--SD)

Cited by 25 publications

References 11 publications

Evaluation of oesophageal reflectance pulse oximetry in major burns patients

Evaluation of oesophageal reflectance pulse oximetry in major burns patients

Esophageal SpO<inf>2</inf> measurements from a pediatric burns-patient: A case study

Thinking Out-of-the-Box: A Non-Standard Application of Standard Pulse-Oximetry and Standard Near-Infrared Spectroscopy in a COVID-19 Patient

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