the association of near-infrared spectroscopy-derived tissue oxygenation measurements with sepsis syndromes, organ dysfunction and mortality in emergency department patients with sepsis近红外spectroscopy-derived协会组织氧测量与脓毒症症状,器官功能障碍和死亡率在急诊科脓毒症患者.pdf

Shapiro et al. Critical Care 2011, 15:R223 /content/15/5/R223 RESEARCH Open Access The association of near-infrared spectroscopy- derived tissue oxygenation measurements with sepsis syndromes, organ dysfunction and mortality in emergency department patients with sepsis 1* 2 3 1 1 4 Nathan I Shapiro , Ryan Arnold , Robert Sherwin , Jennifer O’Connor , Gabriel Najarro , Sam Singh , 2 5 2,6 5 David Lundy , Teresa Nelson , Stephen W Trzeciak and Alan E Jones , for the Emergency Medicine Shock Research Network (EMShockNet) Abstract Introduction: Near-infrared spectroscopy (NIRS) noninvasively measures peripheral tissue oxygen saturation (StO ). 2 NIRS may be utilized along with a vascular occlusion test, in which limb blood flow is temporarily occluded and released, to quantify a tissue bed’s rate of oxygen exchange during ischemia and recovery. The objective of this study was to test the hypothesis that NIRS-derived StO2 measures (StO2 initial, StO2 occlusion and StO2 recovery) identify patients who are in shock and at increased risk of organ dysfunction (Sequential Organ Failure Assessment (SOFA) score ≥ 2 at 24 hours) and dying in the hospital. Methods: This prospective, observational study comprised a convenience sample of three cohorts of adult patients (age 17 years) at three urban university emergency departments: (1) a septic shock cohort (systolic blood pressure 90 after fluid challenge; the “SHOCK” cohort, n = 58), (2) a sepsis without shock cohor