Correlation of near-infrared spectroscopy with perfusion parameters at the hepatic and systemic levels in an endotoxemic shock model.
BACKGROUND
To determine the correlation of near-infrared spectrophotometry (NIRS) readings from the liver surface with invasive measurements of blood flow and tissue perfusion parameters in an animal model of endotoxemic shock.


METHODS
Laparotomy was performed in 12 Yorkshire piglets, and ultrasound blood flow probes were placed on the hepatic artery and portal vein. Hepatic vein, portal vein, and femoral artery catheters were inserted for intermittent blood sampling, and a pulmonary artery catheter was inserted via the jugular vein for cardiac output measurements. Near-infrared spectrophotometry optodes were placed across the right hepatic lobe. Endotoxemic shock was induced by continuous infusion of Escherichia coli lipopolysaccharide 055: B5. Pearson correlations were calculated between the perfusion parameters and the near-infrared spectrophotometry (NIRS) readings.


RESULTS
After endotoxemic shock induction, liver blood flow decreased from 144 +/- 36 to 62 +/- 24 ml*min(-1)*100 g(-1) and oxygen delivery to the liver decreased from 20 +/- 6 to 7 +/- 4 ml*min(-1)*100 g(-1). Near-infrared spectrophotometry readings of oxyhemoglobin concentration decreased by 11.7+/-15.1 micromol*L(-1), and readings of deoxyhemoglobin concentration increased by 12.3 +/- micromol*L(-1). There were significant correlations (p < 0.05 for r2 > 0.11) between the oxyhemoglobin readings and liver oxygen delivery (r2 = 0.58), liver blood flow (r2 = 0.73) and cardiac output (r2 = 0.80). Deoxyhemoglobin readings highly correlated (p < 0.05 for r2 > 0.11) with mixed venous lactate (r2 = 0.87) and with hepatic vein lactate (r2 = 0.82).


CONCLUSIONS
Noninvasive near-infrared spectrophotometry measurements of hepatic oxyhemoglobin and deoxyhemoglobin correlate with liver hemodynamics as well as with global and specific organ perfusion parameters and may serve, in the future, as a useful tool to monitor tissue perfusion in septic patients.
Nahum
Elhanan
E
Division of Pediatric Critical Care, University of British Columbia, Vancouver, Canada. nahum@clait.org.il
Skippen
Peter W
PW
Gagnon
Roy E
RE
Macnab
Andrew J
AJ
Skarsgard
Erik D
ED
D000818:Animals; D002302:Cardiac Output / Q000502:physiology*; D004195:Disease Models, Animal; D005263:Femoral Artery / Q000502:physiology; D006499:Hepatic Artery / Q000502:physiology; D008099:Liver / Q000098:blood supply* / Q000378:metabolism; D010100:Oxygen / Q000097:blood; D010108:Oxyhemoglobins / Q000378:metabolism; D010477:Perfusion; D011169:Portal Vein / Q000502:physiology; D011651:Pulmonary Artery / Q000502:physiology; D012039:Regional Blood Flow / Q000502:physiology*; D012772:Shock, Septic / Q000209:etiology / Q000378:metabolism*; D019265:Spectroscopy, Near-Infrared; D034421:Sus scrofa
D010108:Oxyhemoglobins; D010100:Oxygen