Transcutaneous regional venous oximetry: a feasibility study.

Abstract:

BACKGROUND:The arterial pulse oximeter, which was introduced clinically in the 1970s, is a convenient, useful, and now ubiquitous anesthesia monitor. Unfortunately, although percent saturation of arterial hemoglobin is, along with cardiac output and concentration of hemoglobin, one of 3 components of oxygen delivery, it does not indicate whether oxygen delivery to a region of interest is adequate. Knowledge of peripheral or regional venous oxygen saturation (Sxvo₂) may lend insight into analysis of regional oxygen supply and demand. Our goal was to assess the suitability of 3 anatomic sites for the transcutaneous assessment of Sxvo₂. METHODS:Using a Nonin reflectance oximetry probe (provided by Nonin Medical, Plymouth, MN) placed directly over the antecubital, external jugular, and internal jugular veins in 10 volunteers, we measured the absorbance of red and infrared electromagnetic radiation. We performed fast Fourier transformation on these absorbance waveforms. The ratio of pulsatile absorbance of red and infrared radiation at different frequencies was compared with nonpulsatile absorption, and Sxvo₂ was calculated based on previously derived empiric correlations. RESULTS:Estimates of transcutaneous Sxvo₂ ranged from 41% to 97%, with mean values of 75%, 80%, and 80% at the antecubital, external jugular, and internal jugular veins, respectively. Overall, 93% of predicted Sxvo₂ values were < 90%. CONCLUSION:Validation and subsequent improvement of this technique requires correlation of our results with venous blood gas measurements, followed by incorporation of technologies from related fields in oximetry (fetal reflectance oximetry and near-infrared spectroscopy), as well as the development of advanced signal processing techniques.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Thiele RH,Tucker-Schwartz JM,Lu Y,Gillies GT,Durieux ME

doi

10.1213/ANE.0b013e3182166a26

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

1353-7

issue

6

eissn

0003-2999

issn

1526-7598

pii

ANE.0b013e3182166a26

journal_volume

112

pub_type

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