2 of 10 InSpectra StO 2 Systems Ardolic, Ann Emerg Med. 2010;56:S131. Cohn, J Trauma. 2007;62:44. Moore, Int Proc TSIS 2007;111. Quick assessment helps identify hypoperfused patients in seconds Continuous monitor tracks a patient’s response to interventions
3 of 10 What Is StO 2 ? SaO 2 and SpO 2 measure O 2 saturation in the arteries. ScvO 2 measures O 2 saturation in the superior vena cava. SvO 2 measures O 2 saturation in the pulmonary artery. StO 2 measures O 2 saturation in the microcirculation, where O 2 diffuses to tissue cells. Direct measure of tissue oxygenation and sensitive indicator of tissue perfusion status. InSpectra StO 2 StO 2 = hemoglobin oxygen saturation of the microcirculation SaO 2 SpO 2 ScvO 2 SvO 2 Cohn, J Trauma. 2007;62:44 Lima, Crit Care. 2009;13(Suppl 5):S13
4 of 10 Why Measure Thenar Muscle? During shock, blood flow to peripheral muscles and core organs (liver, gut and kidneys) is reduced in order to preserve brain and heart oxygenation Thenar muscle group is peripheral muscle StO 2 measured in thenar allows noninvasive monitoring of early changes in perfusion status during shock and resuscitation Thenar muscles Chalmers, J Physiol. 1967;192:561. Beilman, Shock. 1999;12:196.
5 of 10 StO 2 measurement site Thenar site minimally affected by – age – gender – edema – adipose StO 2 not confounded by hypothermia Crookes, J Trauma. 2005;58:806. Poeze, Int Care Med. 2006;32:788. Beilman, Ann Surg. 2009;249:845.
6 of 10 How Does the Technology Work? Animation image to be inserted
7 of 10 Watching the Value; Watching the Trend Low StO 2 is associated with poor outcomes and should be investigated 75% 100% 0% StO 2 low; assess patient; resuscitate if indicated StO 2 rising toward normal; assess continued resuscitation StO 2 falling; assess patient; resume resuscitation if indicated StO 2 high; usually seen in systemic vasodilation and high CO StO 2 adequate; assess need for further resuscitation; stop if indicated StO 2 Cohn, J Trauma. 2007;62:44.Leone, Anesthesiology. 2009;111:366. Lima, Crit Care. 2009;13(Suppl 5):S13.Sagraves, J Trauma. 2009;67:441.
8 of 10 Stratify Risk & Guide Resuscitation Low StO 2 is associated with poor outcomes Organ dysfunction Mortality Incidence of low StO 2 is high even when vital signs are not alarming Cohn, J Trauma. 2007;62:44.Veening, Crit Care. 2010;14(Suppl 1):P151. Lima, Crit Care. 2009;13(Suppl 5):S13Leone, Anesthesiology. 2009;111:366. Sagraves, J Trauma. 2009;67:441
9 of 10 Emergency Medicine Patients Who May Benefit High Acuity Elderly Trauma Any age Mechanism of injury puts at risk for bleeding May have non-alarming vital signs Medical Bleeding All patients at risk for bleeding/suspected of internal bleeding: -Gastrointestinal -Vaginal -Nasal Over 65 years old with: -Shortness of breath -Chest pain -Abdominal pain -Falls -Weakness -Syncope Critical Care Patients described above Patients considered to be resuscitated; have non-alarming clinical signs Patients requiring active treatment Veening, Crit Care. 2010;14(Suppl 1):P151. Ardolic, Ann Emerg Med. 2010;56:S131.
Your consent to our cookies if you continue to use this website.