Cerebral and peripheral oxygen saturation during red cell transfusion.
BACKGROUND
Changes in regional hemoglobin oxygen saturation occur in response to blood transfusion and can be measured by near infrared spectroscopy.


METHODS
Cerebral (CsO2) and peripheral (PsO2) oxygen saturation were monitored with an INVOS 4100 near infrared spectroscopy oximeter in 29 patients undergoing 84 intraoperative blood transfusions during aortic or spinal surgery. Hemoglobin concentration was measured before and after transfusion. Mean arterial pressure, end tidal carbon dioxide tension, and arterial oxygen saturation were also monitored.


RESULTS
Mean arterial pressure, arterial oxygen saturation and end tidal carbon dioxide tension remained stable during transfusion, while CsO2 rose by a mean (95% CI) of 4.2 (3.2-5.2%; P = 0.001) and PsO2 rose by a mean (95% CI) of 1.6 (0.3-2.8%; P = 0.016). The rise in CsO2 correlated well with the rise in hemoglobin (r = 0.59, P < 0.001) and with the volume transfused (r = 0.58, P < 0.001). PsO2 correlated with the volume transfused (r = 0.35, P = 0.019) but not with hemoglobin concentration (r = 0.08, P = 0.47).


CONCLUSIONS
Near infrared spectroscopy detected significant rises in tissue oxygenation in response to blood transfusion, particularly in the cerebral cortex. CsO2 may be developed into a blood loss monitor if further research confirms our findings.
Torella
Francesco
F
Academic Surgery Unit, South Manchester University Hospital, Southmoor Road, Wythenshawe, Manchester, United Kingdom. FCMTDR@aol.com <FCMTDR@aol.com>
Haynes
Sarah L
SL
McCollum
Charles N
CN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery; D001921:Brain / Q000378:metabolism*; D017707:Erythrocyte Transfusion; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism*; D019265:Spectroscopy, Near-Infrared; D013131:Spine / Q000601:surgery
D010100:Oxygen