| 응급 환자에서 조직 산소포화도와 전신 산소화 지표간의 상관관계: 예비 임상연구 |
| 윤영웅, 조영모, 김형빈, 류지호, 박맹렬, 민문기, 김용인, 박성욱 |
| 부산대학교 의학전문대학원 응급의학교실 |
| Correlation between Tissue Oxygen Saturation and Global Oxygenation Parameters in Emergency Patients: A Pilot Clinical Study |
| Young Woong Yoon, Young Mo Cho, Hyung Bin Kim, Ji Ho Ryu, Maeng Ryul Park, Mun Ki Min, Yong In Kim, Sung Wook Park |
| Department of Emergency Medicine, Pusan National Univerisyty College of Medicine, Pusan, Korea |
| Correspondence |
Sung Wook Park ,Tel: 051) 240-7503,, Fax: 051) 253-6472, Email: psu52156@naver.com,
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Received: January 8, 2016; Revised: January 12, 2016 Accepted: March 22, 2016. Published online: June 30, 2016. |
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| ABSTRACT |
Purpose:
Near-infrared spectroscopy (NIRS) can noninvasively assess changes in tissue oxygen saturation (StO2). The primary concern of the current study is to determine whether StO2 can be used as a surrogate for global oxygenation parameters such as central venous oxygen saturation (ScvO2), lactic acid, and base deficit (BD) in patients presenting to the emergency department (ED).
Method:
This was a prospective, observational study in patients requiring central venous catheter placement, admitted to the ED with complaints classified as infectious and non-infectious etiology. The NIRS sensor (15 mm probe) was applied on the thenar eminence for at least 3 minutes and ScvO2, arterial lactic acid, and BD were measured during insertion of a central venous catheter. Data were analyzed using a simple correlation and Bland-Altman plot.
Results:
A total of 120 patients were enrolled in the study and further classified as an infection (n=39) and a noninfection (n=81) group. Lactic acid BD showed significant correlation with StO2 in total and in non-infection patients but the degree of correlation was weak and these correlations were not observed in infection patients. Approximately 94% of the difference between StO2 and ScvO2 was placed within limit of agreement but there was a risk that StO2 may overestimate ScvO2 when ScvO2 becomes lower. When patients were assigned to two groups according to laboratory results (lactic acid 4.0 mmol/L; BD > 3.0 mmol/L; ScvO2 > 65% or 75%), no significant difference in StO2 was observed between the two groups.
Conclusion:
In ED patients suspected of having systemic hypoperfusion, StO2 showed a weak correlation with lactic acid and BD in non-infection patients and no correlation in infection patients. In addition, as ScvO2 decreased, the difference between StO2 and ScvO2 showed a tendency to increase, and StO2 was much higher than ScvO2 at low ScvO2 level. Therefore, before using StO2 as surrogate for ScvO2, lactic acid and BD in critically ill patients presenting to the ED, further investigation should be conducted to overcome the limitations of NIRS addressed in this study. |
| Key words:
Microcirculation, Spectroscopy Near-Infrared, Tissue oxygen saturation |
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