Impact of congestive heart failure treatment on peripheral microvascular tissue oxygenation.

The authors evaluated peripheral tissue oxygenation during treatment of acutely decompensated congestive heart failure (CHF) to determine whether differences exist between patients who experienced adverse outcomes (AO), defined as death or readmission within 6 months, and patients who did not (non-AO). This prospective, observational study measured differential absorption spectroscopy-derived tissue hemoglobin oxygenation (S(t) O(2) ) in CHF patients from presentation through hospital discharge to determine whether differences between the AO and non-AO groups exist. Of 52 patients, 6 died and 27 were readmitted. In the non-AO group, S(t) O(2) increased from admission to discharge by 5.2% ( P<.01; 95% confidence interval, 1.7%-8.7%). No S(t) O(2) change occurred in the AO group (2.3%; P=.42; 95% CI, -2.2%-6.8%). Tissue oxygenation increased during inpatient treatment in CHF patients without future adverse outcomes, but was unchanged for those who later died or were readmitted. Lack of improvement may be associated with higher rates of death and readmission.