Incremental value of noncerebral somatic tissue oxygenation monitoring for patients undergoing surgery

There is increasing interest in the use of noncerebral somatic tissue oxygen saturation (SstO2) monitoring on the basis of near-infrared spectroscopy in patients undergoing surgery or residing in intensive care unit. The relevant question is whether SstO2 monitoring can improve the quality of care. In this article, we reviewed the clinical application of SstO2 monitoring in acute care, focusing on its use in patients undergoing surgery.

Multiple small cohort studies conducted on pediatric patients reported close associations of SstO2 measurements over different regions such as the splanchnic and renal tissue beds with systemic oxygenation, transfusion, hemodynamic indices, morbidity, and mortality. Conversely, there is paucity of literature on SstO2 monitoring in adult patients. The limited number of reports suggests that SstO2 levels over bulk muscles such as the thenar eminence, forearm, and lower leg during surgery are correlated with postoperative outcomes including postoperative nausea and vomiting and the length of hospital stay in adult patients undergoing surgery. The only pilot, randomized interventional study based on 50 patients undergoing surgery did not find a difference in outcomes on the basis of the use of SstO2 monitoring.

Somatic tissue oxygenation may represent an essential aspect of human physiology in acute care, and it is likely outcome-relevant based on observational cohort studies. Future research should examine whether SstO2-guided care can further improve patient outcomes using randomized controlled trials.