Prognostic relevance of tissue oxygen saturation in patients in the early stage of multiple organ dysfunction syndrome

• Published in: Medizinische Klinik, Intensivmedizin und Notfallmedizin Vol. 114; no. 2; pp. 146 - 153
• Main Authors: Huster, D, Härtel, F, Nuding, S, Schroeder, J, Zhang, Y, Werdan, K, Ebelt, H
• Format: Journal Article
• Language: German
• Published: Germany 01.03.2019
• Subjects: Aged; Female; Humans; Male; Multiple Organ Failure; Oxygen Consumption; Prognosis; Prospective Studies; Spectroscopy, Near-Infrared; Microcirculation; Hypoxia; MODS; Mortality; Tissue oxygen saturation
• ISSN: 2193-6226
• DOI: 10.1007/s00063-018-0438-6

Patients in circulatory shock exhibit insufficient peripheral perfusion to ensure adequate oxygenation of vital organs such as the heart and brain. Early detection of reduced tissue oxygen saturation (S O ) could be used for rapid therapeutic intervention and thus improve the prognosis of patients in the early stage of multiple organ dysfunction syndrome (MODS). A total of 60 patients in the early stage of MODS (APACHE [Acute Physiology and Chronic Health Evaluation] II score ≥20) were investigated in a monocentric, prospective, randomized phase II study. S O was measured using the InSpectraTM S O system and compared with known indicators of hypoxia (peripheral oxygen saturation [S O ], arterial oxygen saturation [S O ], central venous oxygen saturation [S O ], pH, serum lactate). Clinical endpoints of the study were 28-day and 6‑month mortality as well as the need for invasive mechanical ventilation and renal replacement therapy during the hospital stay, respectively. An increased 28-day and 6‑month mortality is found for patients with S O <75% in contrast to patients with S O ≥75%. Correlations of S O with S O , S O , and serum lactate are confirmed. Patients with reduced S O tend to show a higher disease severity as measured by APACHE II score. S O shows prognostic relevance in patients at the early stage of MODS. Thus, the rapid and noninvasive assessment of S O could be useful in risk stratification of these patients.