Tissue Oximetry and Clinical Outcomes.
Philip Bickler1, John Feiner, Mark Rollins
1From the Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California.
Anesthesia and Analgesia
|June 17, 2016
Summary
Tissue oximetry, particularly near-infrared spectroscopy, shows promise for monitoring oxygenation but requires further research. More studies are needed to link tissue oxygen levels to patient outcomes and guide effective therapies for critical care.
Area of Science:
- Critical care medicine
- Biomedical engineering
- Physiology
Background:
- Tissue oximetry technologies aim to detect tissue hypoxia and guide patient therapy.
- Near-infrared spectroscopy (NIRS) is increasingly used to measure tissue oxygenation, particularly in brain and muscle.
- The link between localized tissue oxygen desaturation and global patient outcomes remains speculative.
Purpose of the Study:
- To review the current evidence on tissue oximetry for predicting clinical outcomes.
- To identify key issues that need to be addressed to clarify the relationship between tissue oxygenation and patient outcomes.
- To highlight the need for further research in tissue oxygenation monitoring.
Main Methods:
- Review of existing literature on tissue oximetry and clinical outcomes.
- Focus on near-infrared spectroscopy (NIRS) for assessing venous-weighted hemoglobin oxygen saturation.
- Analysis of current evidence gaps and future research directions.
Main Results:
- While tissue oximetry can indicate localized desaturation (e.g., brain ischemia), its predictive value for global outcomes (mortality, ICU stay) needs more evidence.
- More research is required to establish predictive thresholds for tissue desaturation-related injury.
- Defining interventions and their impact on outcomes based on tissue oxygenation monitoring is crucial.
Conclusions:
- Further research is essential to establish the clinical utility of tissue oximetry in critical care.
- Prospective studies are needed to validate the predictive power of monitoring one organ's oxygenation on other organs and overall outcomes.
- Advancements in technology for measuring and imaging tissue oxygenation are necessary for routine clinical application in high-risk patients.
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