Avtor/Urednik		Strahovnik, Igor
Naslov		Merjenje tkivne oksigenacije pri kritično bolnih
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Univerza v Ljubljani, Medicinska fakulteta
Leto izdaje		2006
Obseg		str. 46
Jezik		slo
Abstrakt		Background. Shock is state of acutely reduced tissue perfusion. In cardiogenic shock oxygen delivery (DO2) is reduced, but oxygen extraction is preserved. In septic shock DO2 is preserved, but oxygen extraction is decreased because of microvascular changes and disturbed metabolism. Global assessment of DO2 and oxygen consumption do not tell us enough about adequacy of regional perfusion. Aim. To assess the value of near infrared spectroscopy (NIRS) in detecting skeletal muscle tissue oxygenation (StO2) in critically ill. Hypotheses. Reproducibility of muscle StO2 is clinically high enough. Skeletal muscle StO2 differs between patients with localised infection, septic shock, cardiogenic shock and healthy volunteers. Methods. In prospective study 17 patients in cardiogenic shock, 14 in septic shock, 14 patients with localised infection, and 15 healthy volunteers were included. Thenar StO2 was measured before (bazStO2), between (4do1StO2) and after (malcsStO2) 90 seconds of upper arm stagnant ischemia at 260 mmHg with InSpectra (Hutchinson Technology Inc., USA). Muscle oxygen extraction (mOER) was calculated as follows: mOER = (1-bazStO2/maksStO2)* 100. Reproducibility was assessed using Bland Altman method (bias < 5%, precison < 8% of absolute variable value), comparing 55 pairs of measurements performed in 5 minute intervals. Results. Reproducibility of bazStO2, 4do1StO2 and maksStO2 was clinically acceptable. Compared to septic shock, in cardiogenic shock there were lower bazStO2 (68,9 +- 10,0% vs. 84,3 +- 10,4%; p < 0,05), maksSt02 (80,8 +- 7,8% vs. 91,8 +- 8,3%; p < 0,05) and 4dolStO2 (-17,4 +- 31,7%/min vs. -9,1 +- 2,6%/min; p < 0,05). mOER was higher in healthy volunteers (11,9 +- 3,8%) and cardiogenic shock (14,8 +- 7,3 %) compared to septic shock (8,1 +- 7,8%) and localised infection (7,6 +- 5,4%) (p < 0,05). (Abstract truncated at 2000 characters)
Deskriptorji		CRITICAL ILLNESS SHOCK, CARDIOGENIC OXYGEN CONSUMPTION MUSCLE, SKELETAL SHOCK, SEPTIC SPECTROSCOPY, NEAR-INFRARED REPRODUCIBILITY OF RESULTS PROSPECTIVE STUDIES