OBJECTIVES: Tissue oxygen saturation (StO(2)) assessed using Near Infrared Spectroscopy and its derived parameters during a vascular occlusion test (VOT) can detect microvascular changes in septic shock patients. General anesthesia (GA) impacts microcirculation. Our aim was to study the effects of general anesthesia on StO(2) and StO(2) derived parameters obtained during VOT in patients referred for cardiac surgery. METHODS: We studied 15 patients referred for cardiac surgery before and after induction of GA. Before GA induction, we also studied 15 healthy volunteers (non patients) in order to compare baseline physiological data between patients and healthy subjects. Hemodynamic and microcirculatory (StO(2), ischemic slope, reperfusion slope, and hyperemic response) data were recorded at each step. We used the Inspectra StO(2) system (Hutchinson Inc, MN, USA) with a sensor placed on the thenar eminence. StO(2) values were obtained at baseline and during a VOT. A sphyngomanometer was placed on the forearm above the StO(2) probe and the cuff was then rapidly inflated 30 mmHg above systolic pressure and was maintained inflated until the StO(2) value reached 40%. It was then rapidly deflated. RESULTS: Healthy volunteers had significantly higher reperfusion slope than patients (348 [251-393] vs. 261 [185-279] %/min; P < 0.05). GA induction induced no significant change in StO(2) value compared to baseline (79 [75-85] vs. 80 [76-86]%; P = 0.57). We observed a significant decrease in ischemic slope (from -12 [-16--8] to -8 [-10--6] %/min; P = 0.004) and in reperfusion slope (from 261 [185-279] %/min to 164 [151-222] %/min; P = 0.008) suggesting a decrease in local metabolic rate and a negative impact on reperfusion reserve induced by anesthesia. CONCLUSION: StO(2) derived parameters during a VOT are impacted by GA induction. These parameters may have potential for microcirculation assessment in patients undergoing surgery.
OBJECTIVES: Tissue oxygen saturation (StO(2)) assessed using Near Infrared Spectroscopy and its derived parameters during a vascular occlusion test (VOT) can detect microvascular changes in septic shockpatients. General anesthesia (GA) impacts microcirculation. Our aim was to study the effects of general anesthesia on StO(2) and StO(2) derived parameters obtained during VOT in patients referred for cardiac surgery. METHODS: We studied 15 patients referred for cardiac surgery before and after induction of GA. Before GA induction, we also studied 15 healthy volunteers (non patients) in order to compare baseline physiological data between patients and healthy subjects. Hemodynamic and microcirculatory (StO(2), ischemic slope, reperfusion slope, and hyperemic response) data were recorded at each step. We used the Inspectra StO(2) system (Hutchinson Inc, MN, USA) with a sensor placed on the thenar eminence. StO(2) values were obtained at baseline and during a VOT. A sphyngomanometer was placed on the forearm above the StO(2) probe and the cuff was then rapidly inflated 30 mmHg above systolic pressure and was maintained inflated until the StO(2) value reached 40%. It was then rapidly deflated. RESULTS: Healthy volunteers had significantly higher reperfusion slope than patients (348 [251-393] vs. 261 [185-279] %/min; P < 0.05). GA induction induced no significant change in StO(2) value compared to baseline (79 [75-85] vs. 80 [76-86]%; P = 0.57). We observed a significant decrease in ischemic slope (from -12 [-16--8] to -8 [-10--6] %/min; P = 0.004) and in reperfusion slope (from 261 [185-279] %/min to 164 [151-222] %/min; P = 0.008) suggesting a decrease in local metabolic rate and a negative impact on reperfusion reserve induced by anesthesia. CONCLUSION: StO(2) derived parameters during a VOT are impacted by GA induction. These parameters may have potential for microcirculation assessment in patients undergoing surgery.
Authors: Stephen M Cohn; Avery B Nathens; Frederick A Moore; Peter Rhee; Juan Carlos Puyana; Ernest E Moore; Gregory J Beilman Journal: J Trauma Date: 2007-01
Authors: Bruce A Crookes; Stephen M Cohn; Scott Bloch; Jose Amortegui; Ronald Manning; Pam Li; Matthew S Proctor; Ali Hallal; Lorne H Blackbourne; Robert Benjamin; Dror Soffer; Fahim Habib; Carl I Schulman; Robert Duncan; Kenneth G Proctor Journal: J Trauma Date: 2005-04
Authors: Yasser Sakr; Marc-Jacques Dubois; Daniel De Backer; Jacques Creteur; Jean-Louis Vincent Journal: Crit Care Med Date: 2004-09 Impact factor: 7.598
Authors: Hernando Gómez; Jaume Mesquida; Peter Simon; Hyung Kook Kim; Juan C Puyana; Can Ince; Michael R Pinsky Journal: Crit Care Date: 2009-11-30 Impact factor: 9.097
Authors: Daniel De Backer; Steven Hollenberg; Christiaan Boerma; Peter Goedhart; Gustavo Büchele; Gustavo Ospina-Tascon; Iwan Dobbe; Can Ince Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Jaap Jan Vos; Marieke Poterman; Laura N Hannivoort; Victor W Renardel De Lavalette; Michel Mrf Struys; Thomas Wl Scheeren; Alain F Kalmar Journal: Perioper Med (Lond) Date: 2014-10-30
Authors: Zühre Uz; Can Ince; Philippe Guerci; Yasin Ince; Renata P Araujo; Bulent Ergin; Matthias P Hilty; Thomas M van Gulik; Bas A de Mol Journal: Perioper Med (Lond) Date: 2018-08-09