[Prognostic relevance of tissue oxygen saturation in patients in the early stage of multiple organ dysfunction syndrome].

BACKGROUND

Patients in circulatory shock exhibit insufficient peripheral perfusion to ensure adequate oxygenation of vital organs such as the heart and brain. Early detection of reduced tissue oxygen saturation (SO) could be used for rapid therapeutic intervention and thus improve the prognosis of patients in the early stage of multiple organ dysfunction syndrome (MODS).

MATERIALS AND METHODS

A total of 60 patients in the early stage of MODS (APACHE [Acute Physiology and Chronic Health Evaluation] II score ≥20) were investigated in a monocentric, prospective, randomized phase II study. SO was measured using the InSpectraTM SO system and compared with known indicators of hypoxia (peripheral oxygen saturation [SO], arterial oxygen saturation [SO], central venous oxygen saturation [SO], pH, serum lactate). Clinical endpoints of the study were 28-day and 6‑month mortality as well as the need for invasive mechanical ventilation and renal replacement therapy during the hospital stay, respectively.

RESULTS

An increased 28-day and 6‑month mortality is found for patients with SO <75% in contrast to patients with SO ≥75%. Correlations of SO with SO, SO, and serum lactate are confirmed. Patients with reduced SO tend to show a higher disease severity as measured by APACHE II score.

CONCLUSION

SO shows prognostic relevance in patients at the early stage of MODS. Thus, the rapid and noninvasive assessment of SO could be useful in risk stratification of these patients.