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Critical Care

, 8:P54 | Cite as

Simultaneous measurements of subcutaneous and intramuscular tissue pO2 in critically ill patients

  • D Ramnarain
  • R Braams
  • L Leenen
Poster presentation
  • 711 Downloads

Keywords

Septic Shock Severe Sepsis Acute Respiratory Distress Syndrome Tissue Oxygen Biceps Brachii 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

The primary goal in the treatment of patients with shock is to restore the tissue perfusion and oxygenation. Clinical endpoints of resuscitation (i.e. bloodpressure, heart rate, urine output and oxygen saturation) give an incomplete or even misleading picture. Tissue oxygen tension (ptO2) reflecting tissue oxygenation may be a useful endpoint; however, in the clinical setting ptO2 measurements subcutaneously (ptO2sc) and in muscle (ptO2im) are both used, although a comparative study has never been performed.

In 18 critically ill patients ptO2sc and ptO2im were simultaneously and continuously measured using polarographic Clark-type electrodes (LICOX Catheter Measurement System, GMS), placed subcutaneously and in the m. biceps brachii of the upper arm.

Eighteen men and two women with septic shock (n = 8), severe sepsis (n = 5), sepsis (n = 1), polytrauma (n = 3) and nonseptic acute respiratory distress syndrome (ARDS) (n = 1) were included. The median age was 60 years (range 22–80 years), and the median APACHE score on admission was 18 (range 10–31). The median duration of tissue oxygen measurements was 5 days (range 2–8 days). Median ptO2 values of different groups are presented in Table 1. Wilcoxon's signed rank test was used to compare changes within the group and a one-way analysis of variance (ANOVA) was used for comparison between the variation of ptO2 values within groups. Although differences between ptO2sc and ptO2im were found in individual patients and between goups, a clear pattern could not be established. Measurement of tissue oxygenation can be performed in subcutaneous tissue as well as in muscle tissue.

Table 1

 

ptO2sc ± SE (mmHg)

ptO2im ± SE (mmHg)

Wilcoxon's signed rank test P

ANOVA P

Septic shock

39.2 ± 1.6

32.1 ± 1.3

0.02*

0.06

Severe sepsis

30.8 ± 1.5

35.4 ± 2.1

0.38

0.05

Sepsis

43.4 ± 3.7

37.4 ± 2.5

0.25

0.19

polytrauma

30.1 ± 1.9

29.2 ± 1.3

0.05

0.05

ARDS

27.5 ± 5.3

37.7 ± 7.4

0.50

0.38

Copyright information

© BioMed Central Ltd. 2004

Authors and Affiliations

  • D Ramnarain
    • 1
  • R Braams
    • 1
  • L Leenen
    • 1
  1. 1.University Medical Centre UtrechtThe Netherlands

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