Chen Yen-Huey, Kao Kuo-Chin, Hsieh Meng-Jer, Leu Shaw-Woei, Huang Chung-Chi
Department of Respiratory Therapy, College of Medicine, Chang Gung University, Taoyuan 33301, Taiwan.
Division of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Linkou. 5, Fu-Hsin St. Gweishan, Taoyuan 33353, Taiwan.
J Clin Med. 2024 Dec 13;13(24):7612. doi: 10.3390/jcm13247612.
: Impaired systemic tissue oxygenation and microvascular perfusion are associated with adverse outcomes in patients with acute respiratory distress syndrome (ARDS). Tissue oxygenation and microvascular reactivity, assessed by using near-infrared spectroscopy (NIRS), are correlated with disease severity in critically ill populations. This study aimed to detect alterations in these factors and their ability to predict outcomes in patients with ARDS. : We performed NIRS measurements on the first (Day 1) and third (Day 3) days after ARDS diagnosis in 29 patients. We recorded the baseline forearm muscle oxygen saturation (StO) and calculated the deoxygenation slope (Deoxy) and reoxygenation (Reoxy) slope. We divided the subjects into 28-day survival and non-survival subgroups to compare microcirculatory and oxygenation status differences. : The Day 1 StO values were significantly higher for the survival subgroup (60.1 ± 13.5%) than the non-survival subgroup (47.2 ± 6.9%) ( = 0.025). The ROC curve showed that Day 1 StO was a significant predictor of 28-day mortality ( = 0.025). There was no significant difference between the Deoxy and Reoxy slopes of the two groups ( > 0.05). The ROC of the Day 1 Reoxy slope for survival prediction (AUC0.74) was not statistically significant ( = 0.074). : Our study showed poor survival outcomes in patients who had lower skeletal muscle StO values in early-stage ARDS. NIRS measurements may provide prognostic value for the survival outcomes in patients with this syndrome.
全身组织氧合受损和微血管灌注与急性呼吸窘迫综合征（ARDS）患者的不良预后相关。通过近红外光谱（NIRS）评估的组织氧合和微血管反应性与危重症人群的疾病严重程度相关。本研究旨在检测这些因素的变化及其预测ARDS患者预后的能力。
我们对29例ARDS诊断后第1天（第1天）和第3天（第3天）的患者进行了NIRS测量。我们记录了基线前臂肌肉氧饱和度（StO），并计算了脱氧斜率（Deoxy）和复氧（Reoxy）斜率。我们将受试者分为28天生存和非生存亚组，以比较微循环和氧合状态差异。
生存亚组第1天的StO值（60.1±13.5%）显著高于非生存亚组（47.2±6.9%）（P = 0.025）。ROC曲线显示，第1天的StO是28天死亡率的显著预测指标（P = 0.025）。两组的脱氧斜率和复氧斜率之间无显著差异（P>0.05）。第1天复氧斜率预测生存的ROC（AUC0.74）无统计学意义（P = 0.074）。
我们的研究表明，ARDS早期骨骼肌StO值较低的患者生存结局较差。NIRS测量可能为该综合征患者的生存结局提供预后价值。
