Objectives: To describe tissue oxygen saturation (StO) in response to a vascular occlusion test using thenar eminence and forearm near-infrared spectroscopy (NIRS) and the association with volume responsiveness after cardiac surgery.
Design: Single-center, prospective, observational cohort study.
Setting: Cardiothoracic intensive care unit.
Participants: Seventy-six post-cardiac surgical adults.
Interventions: Immediately before and 10 minutes after a 250-to-500 mL fluid bolus, StO was measured in response to a vascular occlusion test to calculate tissue deoxygenation (R) and reoxygenation (R) rates. Concurrently, systemic hemodynamic, metabolic, and blood gas variables were collected.
Measurements And Main Results: A total of 203 boluses were captured using thenar NIRS and 141 boluses using forearm NIRS. Approximately 25% of boluses increased cardiac output by ≥15% (volume responders). Thenar and forearm R decreased in responders, but increased (thenar) or remained unchanged (forearm) in nonresponders. A logistic regression model of the association among StO, R and R, and volume responsiveness was significant for thenar measurements (p = 0.001) with an area under the receiver operating characteristic of 0.69 (95% confidence interval: 0.62-0.75). It also was significant (p = 0.02) for forearm measurements, with an area under the receiver operating characteristic of 0.71 (0.62-0.79). R was an independent variable in both instances (odds ratio 0.31 [0.14-0.69], thenar; odds ratio 0.60 [0.45-0.80], forearm). Thenar and forearm NIRS variables were correlated poorly with cardiac output, stroke volume, systemic oxygen delivery and consumption index, mixed venous, and central venous oxygen saturation (Spearman׳s coefficients, r = 0.17-0.46, p < 0.002).
Conclusion: In post-cardiac surgical patients, thenar and forearm NIRS variables were associated with volume responsiveness although not achieving precision necessary for clinical management.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1053/j.jvca.2017.03.019 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Inflammatory markers predict efficacy of immunotherapy in advanced non-small cell lung cancer: a preliminary exploratory study.
Discov Oncol
January 2025
Department of Respiratory Medicine, The First Hospital of Jiaxing (Affiliated Hospital of Jiaxing University), 1882 South Zhonghuan Road, Jiaxing, 314000, Zhejiang, China.
Objective: The purpose of this study is to analyze the predictive value of neutrophil to lymphocyte ratio (NLR), lymphocyte count to monocyte count ratio (LMR), platelet to lymphocyte ratio (PLR), platelet count multiplied by neutrophil count to lymphocyte count ratio (SII), red blood cell distribution width (RDW), packed cell volume (PCV), and plateletcrit (PCT) levels in advanced non-small cell lung cancer (NSCLC) patients treated with PD-1/PD-L1 inhibitors.
Materials And Methods: From March 2019 to August 2023, we screened 104 of 153 patients with stage III unresectable local advanced NSCLC and IV NSCLC who received PD-1/PD-L1 inhibitor therapy at our hospital and met the inclusion and exclusion criteria for analysis. All patients were collected for clinical information, including baseline blood indicator (NLR, PLR, LMR, SII, CRP, RDW, PCV and PCT) levels before PD-1/PD-L1 inhibitor therapy and blood indicator levels and imaging evaluation results every two cycles after PD-1/PD-L1 inhibitor therapy.
Oxygenation targets for endovascular therapy in acute ischemic stroke patients (Oxy-TARGET): protocol for a single-centre, open-label randomised controlled trial.
BMJ Open
January 2025
Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, PR China
Introduction: Preclinical studies have shown that oxygen therapy can improve ischaemic brain tissue oxygen tension, reduce reperfusion injury after revascularisation, promote neuroregeneration and inhibit inflammatory responses potentially exerting a beneficial effect after endovascular treatment (EVT) in patients with acute ischaemic stroke (AIS). However, the optimal fraction of inspired oxygen (FiO) during EVT under general anaesthesia is currently unknown. Therefore, we are conducting a randomised controlled trial (RCT) to evaluate the impact of high-concentration oxygen vs low-concentration normobaric oxygen on early neurological function after EVT.
View Article and Find Full Text PDFSevere maternal morbidity contributed by obstetric hemorrhage: Maryland, 2020-2022.
Am J Obstet Gynecol MFM
January 2025
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St Suite E8527, Baltimore, MD 21205; Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, 550 North Broadway Baltimore, MD 21205.
Background: Obstetric hemorrhage is the leading cause of maternal mortality and severe maternal morbidity (SMM) in Maryland and nationally. Currently, through a quality collaborative, the state is implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on obstetric hemorrhage.
Objective: To describe SMM events contributed by obstetric hemorrhage and their preventability in Maryland.
A survey of resource allocation among canadian cardiac surgery programs during the COVID-19 pandemic.
Heart Lung
January 2025
Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada. Electronic address:
Background: The coronavirus disease 2019(COVID-19) pandemic significantly impacted the lives of patients and healthcare professionals globally. With rapid spread and severe illness, a great deal of healthcare resources including personal, funding, and hospital beds were dedicated to fight the pandemic.
Objectives: This survey looks to characterize how resources were allocated among Canadian cardiac surgery programs, and how this impacted patient care and outcomes.
Enhanced myocardial perfusion in late gestation fetal lambs with impaired left ventricular inflow.
J Physiol
January 2025
Center for Developmental Health, Oregon Health & Science University, Portland, OR, USA.
Robust preclinical models of asymmetric ventricular loading in late gestation reflecting conditions such as hypoplastic left heart syndrome are lacking. We characterized the morphometry and microvascular function of the hypoplastic left ventricle (LV) and remaining right ventricle (RV) in a sham-controlled late gestation fetal lamb model of impaired left ventricular inflow (ILVI). Singleton fetuses were instrumented at ∼120 days gestational age (dGA; term is ∼147 days) with vascular catheters, an aortic flow probe and a deflated left atrial balloon.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!