Skeletal muscle oxygenation in severe trauma patients during haemorrhagic shock resuscitation

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• 作者：Jerome Duret (1)
  Julien Pottecher (4) (5)
  Pierre Bouzat (1) (2) (3)
  Julien Brun (1)
  Anatole Harrois (6) (7)
  Jean-Francois Payen (1) (2) (3)
  Jacques Duranteau (6) (7)
  
  1. Pole Anesth茅sie-R茅animation ; H么pital Michallon ; Boulevard de la Chantourne ; Grenoble ; F-38043 ; France
  4. H么pitaux Universitaires de Strasbourg ; P么le Anesth茅sie R茅animation Chirurgicale SAMU ; H么pital de Hautepierre ; Service d鈥橝nesth茅sie-R茅animation Chirurgicale ; 1 avenue Moli猫re ; F-67098 ; Strasbourg ; France
  5. Universit茅 de Strasbourg ; F茅d茅ration de M茅decine Translationnelle de Strasbourg (FMTS) ; Facult茅 de M茅decine ; Institut de Physiologie ; Equipe d鈥橝ccueil EA3072 鈥淢itochondrie ; stress oxydant et protection musculaire鈥? 11 rue Humann ; F-67000 ; Strasbourg ; France
  2. Universit茅 Joseph Fourier ; Grenoble Institut des Neurosciences ; 6 rue Jules Horowitz ; Grenoble ; F-38043 ; France
  3. INSERM ; U836 ; Chemin Fortun茅 Ferrini ; Grenoble ; F-38042 ; France
  6. AP-HP ; Service d鈥?Anesth茅sie-R茅animation ; H么pitaux Universitaires Paris-Sud ; Universit茅 Paris-Sud ; H么pital de Bic锚tre ; 78 ; rue du G茅n茅ral Leclerc ; F-94275 ; Le Kremlin-Bic锚tre ; France
  7. Laboratoire d鈥橢tude de la Microcirculation ; 鈥淏io-CANVAS ; Biomarqueurs in CardiaNeuroVascular Diseases鈥?UMRS 942 ; 2 Rue Ambroise-Par茅 ; 75010 ; Paris ; France
  
• 刊名：Critical Care
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：19
• 期：1
• 全文大小：468 KB
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• 刊物主题：Intensive / Critical Care Medicine; Emergency Medicine;
• 出版者：BioMed Central
• ISSN：1364-8535

文摘

Introduction Early alterations in tissue oxygenation may worsen patient outcome following traumatic haemorrhagic shock. We hypothesized that muscle oxygenation measured using near-infrared spectroscopy (NIRS) on admission could be associated with subsequent change in the SOFA score after resuscitation. Methods The study was conducted in two Level I trauma centres and included 54 consecutive trauma patients with haemorrhagic shock, presenting within 6聽hours of injury. Baseline tissue haemoglobin oxygen saturation (StO2) in the thenar eminence muscle and StO2 changes during a vascular occlusion test (VOT) were determined at 6聽hours (H6) and 72聽hours (H72) after the admission to the emergency room. Patients showing an improved SOFA score at H72 (SOFA improvers) were compared to those for whom it was unchanged or worse (SOFA non-improvers). Results Of the 54 patients, 34 patients were SOFA improvers and 20 SOFA non-improvers. They had comparable injury severity scores on admission. SOFA improvers had higher baseline StO2 values and a steeper StO2 desaturation slope at H6 compared to the SOFA non-improvers. These StO2 variables similarly correlated with the intra-hospital mortality. The StO2 reperfusion slope at H6 was similar between the two groups of patients. Conclusions Differences in StO2 parameters on admission of traumatic haemorrhagic shock were found between patients who had an improvement in organ failure in the first 72聽hours and those who had unchanged or worse conditions. The use of NIRS to guide the initial management of trauma patients with haemorrhagic shock warrants further investigations.