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Tuesta M, Yáñez-Sepúlveda R, Verdugo-Marchese H, Mateluna C, Alvear-Ordenes I. Near-Infrared Spectroscopy Used to Assess Physiological Muscle Adaptations in Exercise Clinical Trials: A Systematic Review. BIOLOGY 2022; 11:biology11071073. [PMID: 36101451 PMCID: PMC9312707 DOI: 10.3390/biology11071073] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
Abstract
Simple Summary In recent years, physical exercise has been used as a therapeutic strategy in various clinical conditions, with pleiotropic benefits. Near-infrared spectroscopy (NIRS) has been positioned as a tool to analyze effects on muscle oxygenation, also allowing knowledge of adaptations on microvascular levels and muscle metabolism in subjects with central and peripheral vascular alterations, as well as cardiovascular, metabolic, and/or musculoskeletal diseases. This knowledge can help to guide therapeutic exercise specialists in decision making regarding the prescription and follow up of physical exercise as a therapeutic tool in the observation of acute or chronic adaptations to improve efficiency in the treatment and recovery of these patients. This review presents an overview of the effects of exercise clinical trials on muscle oxygenation in different pathologies and the technical characteristics related to the equipment used. Abstract Using muscle oxygenation to evaluate the therapeutic effects of physical exercise in pathologies through near-infrared spectroscopy (NIRS) is of great interest. The aim of this review was to highlight the use of muscle oxygenation in exercise interventions in clinical trials and to present the technological characteristics related to the equipment used in these studies. PubMed, WOS, and Scopus databases were reviewed up to December 2021. Scientific articles that evaluated muscle oxygenation after exercise interventions in the sick adult population were selected. The PEDro scale was used to analyze the risk of bias (internal validity). The results were presented grouped in tables considering the risk of bias scores, characteristics of the devices, and the effects of exercise on muscle oxygenation. All the stages were carried out using preferred reporting items for systematic reviews and meta-analyses (PRISMA). The search strategy yielded 820 clinical studies, of which 18 met the eligibility criteria. This review detailed the characteristics of 11 NIRS devices used in clinical trials that used physical exercise as an intervention. The use of this technology made it possible to observe changes in muscle oxygenation/deoxygenation parameters such as tissue saturation, oxyhemoglobin, total hemoglobin, and deoxyhemoglobin in clinical trials of patients with chronic disease. It was concluded that NIRS is a non-invasive method that can be used in clinical studies to detect the effects of physical exercise training on muscle oxygenation, hemodynamics, and metabolism. It will be necessary to unify criteria such as the measurement site, frequency, wavelength, and variables for analysis. This will make it possible to compare different models of exercise/training in terms of time, intensity, frequency, and type to obtain more precise conclusions about their benefits for patients.
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Affiliation(s)
- Marcelo Tuesta
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile;
- Laboratory of Sport Sciences, Centro de Medicina Deportiva Sports MD, Viña del Mar 2521156, Chile;
| | - Rodrigo Yáñez-Sepúlveda
- Applied Physiology Laboratory (FISAP), Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
- School of Education, Pedagogy in Physical Education, Universidad Viña del Mar, Viña del Mar 2572007, Chile
| | | | - Cristián Mateluna
- Physical Education School, Pontificia Universidad Católica de Valparaíso, Valparaíso 2530388, Chile;
| | - Ildefonso Alvear-Ordenes
- Applied Physiology Laboratory (FISAP), Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain;
- Correspondence:
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Bockholt R, Paschke S, Heubner L, Ibarlucea B, Laupp A, Janićijević Ž, Klinghammer S, Balakin S, Maitz MF, Werner C, Cuniberti G, Baraban L, Spieth PM. Real-Time Monitoring of Blood Parameters in the Intensive Care Unit: State-of-the-Art and Perspectives. J Clin Med 2022; 11:jcm11092408. [PMID: 35566534 PMCID: PMC9100654 DOI: 10.3390/jcm11092408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023] Open
Abstract
The number of patients in intensive care units has increased over the past years. Critically ill patients are treated with a real time support of the instruments that offer monitoring of relevant blood parameters. These parameters include blood gases, lactate, and glucose, as well as pH and temperature. Considering the COVID-19 pandemic, continuous management of dynamic deteriorating parameters in patients is more relevant than ever before. This narrative review aims to summarize the currently available literature regarding real-time monitoring of blood parameters in intensive care. Both, invasive and non-invasive methods are described in detail and discussed in terms of general advantages and disadvantages particularly in context of their use in different medical fields but especially in critical care. The objective is to explicate both, well-known and frequently used as well as relatively unknown devices. Furtehrmore, potential future direction in research and development of realtime sensor systems are discussed. Therefore, the discussion section provides a brief description of current developments in biosensing with special emphasis on their technical implementation. In connection with these developments, the authors focus on different electrochemical approaches to invasive and non-invasive measurements in vivo.
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Affiliation(s)
- Rebecca Bockholt
- Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, 01309 Dresden, Germany; (R.B.); (S.P.); (L.H.); (A.L.)
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
| | - Shaleen Paschke
- Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, 01309 Dresden, Germany; (R.B.); (S.P.); (L.H.); (A.L.)
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
| | - Lars Heubner
- Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, 01309 Dresden, Germany; (R.B.); (S.P.); (L.H.); (A.L.)
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
| | - Bergoi Ibarlucea
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
- Institute for Materials Science and Max Bergmann Center of Biomaterials, Center for Advancing Electronics Dresden, Technische Universität Dresden, 01069 Dresden, Germany;
| | - Alexander Laupp
- Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, 01309 Dresden, Germany; (R.B.); (S.P.); (L.H.); (A.L.)
| | - Željko Janićijević
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
- Institute of Radiopharmaceutical Cancer Research, Helmholtz Center Dresden Rossendorf e.V., Bautzner Landstrasse 400, 01328 Dresden, Germany
| | - Stephanie Klinghammer
- Institute for Materials Science and Max Bergmann Center of Biomaterials, Center for Advancing Electronics Dresden, Technische Universität Dresden, 01069 Dresden, Germany;
| | - Sascha Balakin
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
- Institute for Materials Science and Max Bergmann Center of Biomaterials, Center for Advancing Electronics Dresden, Technische Universität Dresden, 01069 Dresden, Germany;
| | - Manfred F. Maitz
- Leibniz-Institut für Polymerforschung Dresden e.V., 01069 Dresden, Germany; (M.F.M.); (C.W.)
| | - Carsten Werner
- Leibniz-Institut für Polymerforschung Dresden e.V., 01069 Dresden, Germany; (M.F.M.); (C.W.)
| | - Gianaurelio Cuniberti
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
- Institute for Materials Science and Max Bergmann Center of Biomaterials, Center for Advancing Electronics Dresden, Technische Universität Dresden, 01069 Dresden, Germany;
| | - Larysa Baraban
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
- Institute of Radiopharmaceutical Cancer Research, Helmholtz Center Dresden Rossendorf e.V., Bautzner Landstrasse 400, 01328 Dresden, Germany
| | - Peter Markus Spieth
- Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, 01309 Dresden, Germany; (R.B.); (S.P.); (L.H.); (A.L.)
- Else Kröner-Fresenius Center for Digital Health (EKFZ), Technische Universität Dresden (TU Dresden), 01309 Dresden, Germany; (B.I.); (Ž.J.); (S.B.); (G.C.); (L.B.)
- Correspondence: ; Tel.: +49-351-4581-6006
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Gray SL, Hall KE, Powell LL, Schildt J, Brearley AM, Beilman GJ. Tissue oxygen saturation in dogs with acute hemorrhage. J Vet Emerg Crit Care (San Antonio) 2018; 28:408-414. [PMID: 30117666 DOI: 10.1111/vec.12752] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 11/02/2016] [Accepted: 11/08/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate initial tissue hemoglobin oxygen saturation (StO2 ) in dogs presenting to an emergency room (ER) for acute hemorrhage. DESIGN Prospective, observational study. SETTING University veterinary teaching hospital. ANIMALS Thirty-eight dogs with acute hemorrhage were enrolled between July 2009 and October 2010. Seventy-eight normal dogs from a previous observational study were included to represent healthy controls ("no shock"). INTERVENTIONS Tissue oxygen saturation measurement was obtained at enrollment on dogs presented to the ER for acute hemorrhage. Baseline clinicopathologic (CBC, serum biochemical profile, prothrombin time, and activated partial thromboplastin time) and physiologic (plasma lactate concentration, venous blood gas, blood pressure, and hemoglobin oxygen saturation by pulse oximetry) data were recorded from all patients with hemorrhage. An ER clinician blinded to the StO2 value guided patient management. Patient survival to discharge from the hospital in the study group was recorded. Once data collection was complete, 3 emergency and critical care clinicians blinded to the StO2 data retrospectively classified patients into 1 of 4 shock categories (no shock, mild, moderate, or severe shock). MEASUREMENTS AND MAIN RESULTS The historical group of healthy dogs had higher StO2 concentrations compared to the dogs classified with shock at all 3 levels (mild, moderate, and severe, P = 0.0006, <0.0001, and 0.0018, respectively); however, there was no statistical difference in StO2 between the levels of shock. A cut-off StO2 value of 87.6% identified a patient as having shock (area under the curve: 0.824, 95% confidence interval 0.749, 0.899). CONCLUSIONS Dogs with hemorrhagic shock have lower StO2 than a population of healthy dogs.
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Affiliation(s)
- Sarah L Gray
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN, USA
| | - Kelly E Hall
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN, USA
| | - Lisa L Powell
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN, USA
| | - Julie Schildt
- Department of Veterinary Clinical Sciences, University of Minnesota, Saint Paul, MN, USA
| | - Ann M Brearley
- Division of Biostatistics, University of Minnesota, Saint Paul, MN, USA
| | - Greg J Beilman
- Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, USA
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Thomassen SA, Kjærgaard B, Olsen Alstrup AK, Munk OL, Frøkiær J, Larsson A, Rasmussen BS. Muscle Tissue Saturation Compared With Muscle Tissue Perfusion During Low Blood Flows: An Experimental Study. J Cardiothorac Vasc Anesth 2017; 31:2065-2071. [DOI: 10.1053/j.jvca.2017.03.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Indexed: 01/09/2023]
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Benedik PS, Hamlin SK. The physiologic role of erythrocytes in oxygen delivery and implications for blood storage. Crit Care Nurs Clin North Am 2016; 26:325-35. [PMID: 25169686 DOI: 10.1016/j.ccell.2014.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Erythrocytes are not just oxygen delivery devices but play an active metabolic role in modulating microvascular blood flow. Hemoglobin and red blood cell morphology change as local oxygen levels fall, eliciting the release of adenosine triphosphate and nitric oxide to initiate local vasodilation. Aged erythrocytes undergo physical and functional changes such that some of the red cell's most physiologically helpful attributes are diminished. This article reviews the functional anatomy and applied physiology of the erythrocyte and the microcirculation with an emphasis on how erythrocytes modulate microvascular function. The effects of cell storage on the metabolic functions of the erythrocyte are also briefly discussed.
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Affiliation(s)
- Penelope S Benedik
- Department of Acute and Continuing Care, School of Nursing, University of Texas Health Science Center at Houston, 6901 Bertner Street, SON 682, Houston, TX 77030, USA.
| | - Shannan K Hamlin
- Nursing Research and Evidence-Based Practice, Houston Methodist Hospital, 6565 Fannin, MGJ 11-017, Houston, TX 77030, USA
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Budidha K, Abay TY, Kyriacou PA. Investigation of photoplethysmography, laser doppler flowmetry and near infrared spectroscopy during induced thermal stress. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:6417-20. [PMID: 26737761 DOI: 10.1109/embc.2015.7319861] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Continuous assessment of blood flow, blood volume, and blood and tissue oxygenation are of vital importance in critically ill patients. Photoplethysmography (PPG), Pulse Oximetry (PO), Laser Doppler Flowmetry (LDF) and Near Infrared Spectroscopy (NIRS) are amongst the most widely used techniques to monitor such perfusion parameters. In this study, we investigated the feasibility of using dual-wavelength PPG signals on providing comparable information as LDF and NIRS, besides arterial oxygen saturation (SpO2) as measured by pulse oximetry. All three techniques were investigated on six healthy volunteers during whole-body cold exposure. PPG and LDF sensors were attached on the finger and hand respectively, while NIRS was positioned above the left forearm. Measurements at room temperature (24°C) were followed and preceded by a cold exposure (10°C). The results showed that changes in pulsatile PPG amplitudes and hemoglobin concentration estimated from finger PPG signals indicate strong similarities with gold-standard LDF and NIRS measurements.
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Quandt BM, Scherer LJ, Boesel LF, Wolf M, Bona GL, Rossi RM. Body-monitoring and health supervision by means of optical fiber-based sensing systems in medical textiles. Adv Healthc Mater 2015; 4:330-55. [PMID: 25358557 DOI: 10.1002/adhm.201400463] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/24/2014] [Indexed: 11/11/2022]
Abstract
Long-term monitoring with optical fibers has moved into the focus of attention due to the applicability for medical measurements. Within this Review, setups of flexible, unobtrusive body-monitoring systems based on optical fibers and the respective measured vital parameters are in focus. Optical principles are discussed as well as the interaction of light with tissue. Optical fiber-based sensors that are already used in first trials are primarily selected for the section on possible applications. These medical textiles include the supervision of respiration, cardiac output, blood pressure, blood flow and its saturation with hemoglobin as well as oxygen, pressure, shear stress, mobility, gait, temperature, and electrolyte balance. The implementation of these sensor concepts prompts the development of wearable smart textiles. Thus, current sensing techniques and possibilities within photonic textiles are reviewed leading to multiparameter designs. Evaluation of these designs should show the great potential of optical fibers for the introduction into textiles especially due to the benefit of immunity to electromagnetic radiation. Still, further improvement of the signal-to-noise ratio is often necessary to develop a commercial monitoring system.
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Affiliation(s)
- Brit M. Quandt
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Laboratory for Protection and Physiology; Lerchenfeldstrasse 5, 9016 St. Gallen Switzerland
- ETH Zurich, Department of Information Technology and Electrical Engineering; Gloriastrasse 35 8092 Zurich Switzerland
| | | | - Luciano F. Boesel
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Laboratory for Protection and Physiology; Lerchenfeldstrasse 5, 9016 St. Gallen Switzerland
| | - Martin Wolf
- Division of Neonatology; University Hospital Zurich; Frauenklinikstrasse 10 8091 Zurich Switzerland
| | - Gian-Luca Bona
- ETH Zurich, Department of Information Technology and Electrical Engineering; Gloriastrasse 35 8092 Zurich Switzerland
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Überlandstrasse 129 8600 Dübendorf Switzerland
| | - René M. Rossi
- Empa-Swiss Federal Laboratories for Materials Science and Technology; Laboratory for Protection and Physiology; Lerchenfeldstrasse 5, 9016 St. Gallen Switzerland
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Emergency whole-blood use in the field: a simplified protocol for collection and transfusion. Shock 2014; 41 Suppl 1:76-83. [PMID: 24365879 DOI: 10.1097/shk.0000000000000114] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Military experience and recent in vitro laboratory data provide a biological rationale for whole-blood use in the treatment of exsanguinating hemorrhage and have renewed interest in the reintroduction of fresh whole blood and cold-stored whole blood to patient care in austere environments. There is scant evidence to support, in a field environment, that a whole blood-based resuscitation strategy is superior to a crystalloid/colloid approach even when augmented by a limited number of red blood cell (RBC) and plasma units. Recent retrospective evidence suggests that, in this setting, resuscitation with a full compliment of RBCs, plasma, and platelets may offer an advantage, especially under conditions where evacuation is delayed. No current evacuation system, military or civilian, is capable of providing RBC, plasma, and platelet units in a prehospital environment, especially in austere settings. As a result, for the vast minority of casualties, in austere settings, with life-threatening hemorrhage, it is appropriate to consider a whole blood-based resuscitation approach to provide a balanced response to altered hemostasis and oxygen debt, with the goal of reducing the risk of death from hemorrhagic shock. To optimize the successful use of fresh whole blood/cold-stored whole blood in combat field environments, proper planning and frequent training to maximize efficiency and safety will be required. Combat medics will need proper protocol-based guidance and education if whole-blood collection and transfusion are to be successfully and safely performed in austere environments. In this article, we present the Norwegian Naval Special Operation Commando unit-specific remote damage control resuscitation protocol, which includes field collection and transfusion of whole blood. This protocol can serve as a template for others to use and adjust for their own military or civilian unit-specific needs and capabilities for care in austere environments.
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Abstract
A variety of point-of-care monitors for the measurement of hematocrit, hemoglobin, blood gas with electrolytes, and lactate can be used also in the prehospital setting for optimizing and individualizing trauma resuscitation. Point-of-care coagulation testing with activated prothrombin test, prothrombin test, and activated coagulation/clotting time tests is available for prehospital use. Although robust, battery driven, and easy to handle, many devices lack documentation for use in prehospital care. Some of the devices correspond poorly to corresponding laboratory analyses in acute trauma coagulopathy and at lower hematocrits. In trauma, viscoelastic tests such as rotational thromboelastometry and thromboelastography can rapidly detect acute trauma coagulopathy and give an overall dynamic picture of the hemostatic system and the interaction between its different components: coagulation activation, fibrin polymerization, fibrin platelet interactions within the clot, and fibrinolysis. Rotational thromboelastometry is shock resistant and has the potential to be used outside the hospital setting to guide individualized coagulation factor and blood component therapies. Sonoclot and Rheorox are two small viscoelastic instruments with one-channel options, but with less documentation. The point-of-care market for coagulation tests is quickly expanding, and new devices are introduced all the time. Still they should be better adopted to prehospital conditions, small, robust, battery charged, and rapid and use small sample volumes and whole blood.
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Weinberg L, Kearsey I, Tjoakarfa C, Matalanis G, Galvin S, Carson S, Bellomo R, McNicol L, McCall P. Haemostatic management for aortic valve replacement in a patient with advanced liver disease. World J Clin Cases 2014; 2:596-603. [PMID: 25325074 PMCID: PMC4198416 DOI: 10.12998/wjcc.v2.i10.596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 06/25/2014] [Accepted: 07/29/2014] [Indexed: 02/05/2023] Open
Abstract
Redo-sternotomy and aortic valve replacement in patients with advanced liver disease is rare and associated with a prohibitive morbidity and mortality. Refractory coagulopathy is common and a consequence of intense activation of the coagulation system that can be triggered by contact of blood with the cardiopulmonary bypass circuitry, bypass-induced fibrinolysis, platelet activation and dysfunction, haemodilution, surgical trauma, hepatic decompensation and hypothermia. Management can be further complicated by right heart dysfunction, porto-pulmonary hypertension, poor myocardial protection, and hepato-renal syndrome. Complex interactions between coagulation/fibrinolysis and systemic inflammatory response syndrome reactions like “post-perfusion-syndrome” also compound haemostatic failure. Given the limited information available for the specific management and prevention of cardiopulmonary bypass-induced haemostatic failure, this report serves to guide the anaesthesia and medical management of future cases of a similar kind. We discuss our multimodal management of haemostatic failure using pharmacological strategies, thromboelastography, continuous cerebral and liver oximetry, and continuous cardiac output monitoring.
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Engbers S, Boysen SR, Engbers J, Chalhoub S. A comparison of tissue oxygen saturation measurements by 2 different near-infrared spectroscopy monitors in 21 healthy dogs. J Vet Emerg Crit Care (San Antonio) 2014; 24:536-44. [DOI: 10.1111/vec.12229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 07/28/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Sarah Engbers
- Department of Veterinary Clinical and Diagnostic Sciences; Faculty of Veterinary Medicine; University of Calgary; Calgary Alberta Canada
| | - Søren R. Boysen
- Department of Veterinary Clinical and Diagnostic Sciences; Faculty of Veterinary Medicine; University of Calgary; Calgary Alberta Canada
| | - Jordan Engbers
- Faculty of Medicine; Clinical Research Unit; Calgary Alberta Canada
| | - Serge Chalhoub
- Department of Veterinary Clinical and Diagnostic Sciences; Faculty of Veterinary Medicine; University of Calgary; Calgary Alberta Canada
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Macdonald SPJ, Brown SGA. Near-infrared spectroscopy in the assessment of suspected sepsis in the emergency department. Emerg Med J 2013; 32:404-8. [PMID: 24154943 DOI: 10.1136/emermed-2013-202956] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/06/2013] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND AIMS The conventional approach to sepsis resuscitation involves early interventions targeting global oxygenation and macro-haemodynamic variables such as central venous and systemic arterial pressures. There is increasing recognition of the importance of microcirculatory changes in shock states, including sepsis, and the relationship of these to outcome. Near-infrared spectroscopy (NIRS) is a recently developed non-invasive technology that measures tissue oxygen saturations (StO2), which may be an indirect measure of the adequacy of the microcirculation. StO2 measurements, therefore, have the potential to identify patients who are at risk of progressing to organ dysfunction and could be used to guide resuscitation. This article reviews the current state of knowledge of NIRS in the setting of sepsis, examining its application, validity and prognostic value. METHODS A search of the relevant literature was performed using Medline, Embase and Cochrane databases, and a qualitative analysis was undertaken. RESULTS A limited number of observational studies, mostly conducted among patients with severe sepsis, have shown that NIRS may correlate with severity of illness but demonstrate a variable relationship between StO2 and outcome. CONCLUSIONS Outstanding questions still remain as to whether NIRS can help to risk-stratify patients with suspected sepsis in the emergency department and the utility of StO2 as a resuscitation target.
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Affiliation(s)
- Stephen P J Macdonald
- Discipline of Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research, Perth, Western Australia, Australia Department of Emergency Medicine, Armadale Health Service, Armadale, Western Australia, Australia
| | - Simon G A Brown
- Discipline of Emergency Medicine, University of Western Australia, Perth, Western Australia, Australia Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research, Perth, Western Australia, Australia Department of Emergency Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
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Evaluation of Multiple Modes of Oximetry Monitoring as an Index of Splanchnic Blood Flow in a Newborn Lamb Model of Hypoxic, Ischemic, and Hemorrhagic Stress. Shock 2013; 39:501-6. [DOI: 10.1097/shk.0b013e3182934056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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