Oxygen tissue saturation is lower in nonsurvivors than in survivors after early resuscitation of septic shock.
BACKGROUND
Growing evidence suggests that the microvascular dysfunction is the key element of the pathogenesis of septic shock. This study's purpose was to explore whether the outcome of septic shock patients after early resuscitation using early goal-directed therapy is related to their muscle tissue oxygenation.


METHODS
Tissue oxygen saturation (Sto2) was monitored in septic shock patients using a tissue spectrometer (InSpectra Model 325; Hutchinson Technology, Hutchinson, MN). For the purpose of this retrospective study, the Sto2 values were collected at the first measurement done after the macrohemodynamic variables (mean arterial pressure, urine output, central venous saturation in oxygen) were optimized.


RESULTS
After the hemodynamic variables were corrected, no difference was observed between the nonsurvivors and survivors, with the exception of pulse oximetry saturation (94% [92-97%] vs. 97% [94-99%], P = 0.04). The Sto2 values were significantly lower in the nonsurvivors than in the survivors (73% [68-82%] vs. 84% [81-90%], P = 0.02). No correlations were found between the Sto2 and Spo2 (P = 0.7).


CONCLUSIONS
In septic shock patients, tissue oxygen saturation below 78% is associated with increased mortality at day 28. Further investigations are required to determine whether the correction of an impaired level of tissue oxygen saturation may improve the outcome of these patients.
Leone
Marc
M
Service d'Anesthésie et de Réanimation, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille and Université de la Méditerranée, Marseille, France. marc.leone@ap-hm.fr
Blidi
Sami
S
Antonini
François
F
Meyssignac
Bertrand
B
Bordon
Sébastien
S
Garcin
Frédéric
F
Charvet
Aude
A
Blasco
Valéry
V
Albanèse
Jacques
J
Martin
Claude
C
D000328:Adult; D000368:Aged; D002196:Capillaries / Q000473:pathology; D002245:Carbon Dioxide / Q000097:blood; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism; D010092:Oximetry; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology*; D012372:ROC Curve; D012151:Resuscitation; D012189:Retrospective Studies; D012772:Shock, Septic / Q000378:metabolism* / Q000401:mortality* / Q000503:physiopathology; D019265:Spectroscopy, Near-Infrared; D016019:Survival Analysis; D017741:Survivors
D002245:Carbon Dioxide; D003404:Creatinine; D010100:Oxygen