Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Intensive Care Medicine
Published in: Intensive Care Medicine 4/2012

Open Access 01-04-2012 | Original

Peripheral vasoconstriction influences thenar oxygen saturation as measured by near-infrared spectroscopy

Authors: Alexandre Lima, Michel Egide van Genderen, Eva Klijn, Jan Bakker, Jasper van Bommel

Published in: Intensive Care Medicine | Issue 4/2012

Login to get access

Abstract

Purpose

Near-infrared spectroscopy has been used as a noninvasive monitoring tool for tissue oxygen saturation (StO2) in acutely ill patients. This study aimed to investigate whether local vasoconstriction induced by body surface cooling significantly influences thenar StO2 as measured by InSpectra model 650.

Methods

Eight healthy individuals (age 26 ± 6 years) participated in the study. Using a cooling blanket, we aimed to cool the entire body surface to induce vasoconstriction in the skin without any changes in central temperature. Thenar StO2 was noninvasively measured during a 3-min vascular occlusion test using InSpectra model 650 with a 15-mm probe. Measurements were analyzed for resting StO2 values, rate of StO2 desaturation (RdecStO2, %/min), and rate of StO2 recovery (RincStO2, %/s) before, during, and after skin cooling. Measurements also included heart rate (HR), mean arterial pressure (MAP), cardiac output (CO), stroke volume (SV), capillary refill time (CRT), forearm-to-fingertip skin-temperature gradient (Tskin-diff), perfusion index (PI), and tissue hemoglobin index (THI).

Results

In all subjects MAP, CO, SV, and core temperature did not change during the procedure. Skin cooling resulted in a significant decrease in StO2 from 82% (80–87) to 72% (70–77) (P < 0.05) and in RincStO2 from 3.0%/s (2.8–3.3) to 1.7%/s (1.1–2.0) (P < 0.05). Similar changes in CRT, Tskin-diff, and PI were also observed: from 2.5 s (2.0–3.0) to 8.5 s (7.2–11.0) (P < 0.05), from 1.0°C (−1.6–1.8) to 3.1°C (1.8–4.3) (P < 0.05), and from 10.0% (9.1–11.7) to 2.5% (2.0–3.8), respectively. The THI values did not change significantly.

Conclusion

Peripheral vasoconstriction due to body surface cooling could significantly influence noninvasive measurements of thenar StO2 using InSpectra model 650 with 15-mm probe spacing.
Literature
1.
Buono MJ, Miller PW, Hom C, Pozos RS, Kolkhorst FW (2005) Skin blood flow affects in vivo near-infrared spectroscopy measurements in human skeletal muscle. Jpn J Physiol 55:241–244PubMedCrossRef
2.
Takahashi T, Takikawa Y, Kawagoe R, Shibuya S, Iwano T, Kitazawa S (2011) Influence of skin blood flow on near-infrared spectroscopy signals measured on the forehead during a verbal fluency task. Neuroimage 57:991–1002PubMedCrossRef
3.
De Blasi RA (2008) Is muscle StO2 an appropriate variable for investigating early compensatory tissue mechanisms under physiological and pathological conditions? Intensive Care Med 34:1557–1559PubMedCrossRef
4.
Yanagisawa O, Homma T, Okuwaki T, Shimao D, Takahashi H (2007) Effects of cooling on human skin and skeletal muscle. Eur J Appl Physiol 100:737–745PubMedCrossRef
5.
Lima A, van Bommel J, Sikorska K, van Genderen M, Klijn E, Lesaffre E, Ince C, Bakker J (2011) The relation of near-infrared spectroscopy with changes in peripheral circulation in critically ill patients. Crit Care Med 39:1649–1654PubMedCrossRef
6.
Sessler DI (2003) Skin-temperature gradients are a validated measure of fingertip perfusion. Eur J Appl Physiol 89:401–402PubMedCrossRef
7.
Lima AP, Beelen P, Bakker J (2002) Use of a peripheral perfusion index derived from the pulse oximetry signal as a noninvasive indicator of perfusion. Crit Care Med 30:1210–1213PubMedCrossRef
8.
Squara P, Denjean D, Estagnasie P, Brusset A, Dib JC, Dubois C (2007) Noninvasive cardiac output monitoring (NICOM): a clinical validation. Intensive Care Med 33:1191–1194PubMedCrossRef
9.
Skarda DE, Mulier KE, Myers DE, Taylor JH, Beilman GJ (2007) Dynamic near-infrared spectroscopy measurements in patients with severe sepsis. Shock 27:348–353PubMedCrossRef
10.
Mulier KE, Skarda DE, Taylor JH, Myers DE, McGraw MK, Gallea BL, Beilman GJ (2008) Near-infrared spectroscopy in patients with severe sepsis: correlation with invasive hemodynamic measurements. Surg Infect (Larchmt) 9:515–519CrossRef
11.
Lima A, Jansen TC, van Bommel J, Ince C, Bakker J (2009) The prognostic value of the subjective assessment of peripheral perfusion in critically ill patients. Crit Care Med 37:934–938PubMedCrossRef
12.
Kaplan LJ, McPartland K, Santora TA, Trooskin SZ (2001) Start with a subjective assessment of skin temperature to identify hypoperfusion in intensive care unit patients. J Trauma 50:620–627PubMedCrossRef
13.
McKinley BA, Marvin RG, Cocanour CS, Moore FA (2000) Tissue hemoglobin O2 saturation during resuscitation of traumatic shock monitored using near infrared spectrometry. J Trauma 48:637–642PubMedCrossRef
14.
Crookes BA, Cohn SM, Bloch S, Amortegui J, Manning R, Li P, Proctor MS, Hallal A, Blackbourne LH, Benjamin R, Soffer D, Habib F, Schulman CI, Duncan R, Proctor KG (2005) Can near-infrared spectroscopy identify the severity of shock in trauma patients? J Trauma 58:806–813PubMedCrossRef
15.
Ikossi DG, Knudson MM, Morabito DJ, Cohen MJ, Wan JJ, Khaw L, Stewart CJ, Hemphill C, Manley GT (2006) Continuous muscle tissue oxygenation in critically injured patients: a prospective observational study. J Trauma 61:780–788PubMedCrossRef
16.
Cohn SM, Nathens AB, Moore FA, Rhee P, Puyana JC, Moore EE, Beilman GJ (2007) Tissue oxygen saturation predicts the development of organ dysfunction during traumatic shock resuscitation. J Trauma 62:44–54PubMedCrossRef
17.
Thompson MJ, Ninis N, Perera R, Mayon-White R, Phillips C, Bailey L, Harnden A, Mant D, Levin M (2006) Clinical recognition of meningococcal disease in children and adolescents. Lancet 367:397–403PubMedCrossRef
18.
Bartels SA, Bezemer R, de Vries FJ, Milstein DM, Lima A, Cherpanath TG, van den Meiracker AH, van Bommel J, Heger M, Karemaker JM, Ince C (2011) Multi-site and multi-depth near-infrared spectroscopy in a model of simulated (central) hypovolemia: lower body negative pressure. Intensive Care Med 37:671–677PubMedCrossRef
Metadata
Title
Peripheral vasoconstriction influences thenar oxygen saturation as measured by near-infrared spectroscopy
Authors
Alexandre Lima
Michel Egide van Genderen
Eva Klijn
Jan Bakker
Jasper van Bommel
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2012
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-012-2486-3

Other articles of this Issue 4/2012

Intensive Care Medicine 4/2012 Go to the issue

Original

Standard subcutaneous dosing of unfractionated heparin for venous thromboembolism prophylaxis in surgical ICU patients leads to subtherapeutic factor Xa inhibition

Erratum

Erratum to: Recommendations for sepsis management in resource-limited settings

Correspondence

Work of breathing to optimize noninvasive ventilation in bronchiolitis obliterans

Correspondence

Dismissal of the utility of free cortisol measurement is premature

Pediatric Original

Interfaces for long-term noninvasive positive pressure ventilation in children

Correspondence

Effect of do-not-resuscitate orders on the penumbra of care