title: Skeletal muscle oxygenation in severe trauma patients during haemorrhagic shock resuscitation.
abstract: BACKGROUND
  Early alterations in tissue oxygenation may worsen patient outcome following traumatic haemorrhagic shock. We hypothesized that muscle oxygenation measured using near-infrared spectroscopy (NIRS) on admission could be associated with subsequent change in the SOFA score after resuscitation.
  
  
  METHODS
  The study was conducted in two Level I trauma centres and included 54 consecutive trauma patients with haemorrhagic shock, presenting within 6 hours of injury. Baseline tissue haemoglobin oxygen saturation (StO2) in the thenar eminence muscle and StO2 changes during a vascular occlusion test (VOT) were determined at 6 hours (H6) and 72 hours (H72) after the admission to the emergency room. Patients showing an improved SOFA score at H72 (SOFA improvers) were compared to those for whom it was unchanged or worse (SOFA non-improvers).
  
  
  RESULTS
  Of the 54 patients, 34 patients were SOFA improvers and 20 SOFA non-improvers. They had comparable injury severity scores on admission. SOFA improvers had higher baseline StO2 values and a steeper StO2 desaturation slope at H6 compared to the SOFA non-improvers. These StO2 variables similarly correlated with the intra-hospital mortality. The StO2 reperfusion slope at H6 was similar between the two groups of patients.
  
  
  CONCLUSIONS
  Differences in StO2 parameters on admission of traumatic haemorrhagic shock were found between patients who had an improvement in organ failure in the first 72 hours and those who had unchanged or worse conditions. The use of NIRS to guide the initial management of trauma patients with haemorrhagic shock warrants further investigations.
authors.affiliation: Pole Anesthésie-Réanimation, Hôpital Michallon, Boulevard de la Chantourne, Grenoble, F-38043, France. JDuret1@chu-grenoble.fr.
authors.forename: Jerome
authors.initials: J
authors.lastname: Duret
authors.affiliation: Hôpitaux Universitaires de Strasbourg, Pôle Anesthésie Réanimation Chirurgicale SAMU, Hôpital de Hautepierre, Service d'Anesthésie-Réanimation Chirurgicale, 1 avenue Molière, F-67098, Strasbourg, France. julien.pottecher@chru-strasbourg.fr.|Université de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Faculté de Médecine, Institut de Physiologie, Equipe d'Accueil EA3072 "Mitochondrie, stress oxydant et protection musculaire", 11 rue Humann, F-67000, Strasbourg, France. julien.pottecher@chru-strasbourg.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Pottecher
authors.affiliation: Pole Anesthésie-Réanimation, Hôpital Michallon, Boulevard de la Chantourne, Grenoble, F-38043, France. PBouzat@chu-grenoble.fr.|Université Joseph Fourier, Grenoble Institut des Neurosciences, 6 rue Jules Horowitz, Grenoble, F-38043, France. PBouzat@chu-grenoble.fr.|INSERM, U836, Chemin Fortuné Ferrini, Grenoble, F-38042, France. PBouzat@chu-grenoble.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bouzat
authors.affiliation: Pole Anesthésie-Réanimation, Hôpital Michallon, Boulevard de la Chantourne, Grenoble, F-38043, France. JBrun@chu-grenoble.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Brun
authors.affiliation: AP-HP, Service d' Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Hôpital de Bicêtre, 78, rue du Général Leclerc, F-94275, Le Kremlin-Bicêtre, France. anatole.harrois@bct.aphp.fr.|Laboratoire d'Etude de la Microcirculation, "Bio-CANVAS: Biomarqueurs in CardiaNeuroVascular Diseases" UMRS 942, 2 Rue Ambroise-Paré, 75010, Paris, France. anatole.harrois@bct.aphp.fr.
authors.forename: Anatole
authors.initials: A
authors.lastname: Harrois
authors.affiliation: Pole Anesthésie-Réanimation, Hôpital Michallon, Boulevard de la Chantourne, Grenoble, F-38043, France. Jean-Francois.Payen@ujf-grenoble.fr.|Université Joseph Fourier, Grenoble Institut des Neurosciences, 6 rue Jules Horowitz, Grenoble, F-38043, France. Jean-Francois.Payen@ujf-grenoble.fr.|INSERM, U836, Chemin Fortuné Ferrini, Grenoble, F-38042, France. Jean-Francois.Payen@ujf-grenoble.fr.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Payen
authors.affiliation: AP-HP, Service d' Anesthésie-Réanimation, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, Hôpital de Bicêtre, 78, rue du Général Leclerc, F-94275, Le Kremlin-Bicêtre, France. jacques.duranteau@bct.aphp.fr.|Laboratoire d'Etude de la Microcirculation, "Bio-CANVAS: Biomarqueurs in CardiaNeuroVascular Diseases" UMRS 942, 2 Rue Ambroise-Paré, 75010, Paris, France. jacques.duranteau@bct.aphp.fr.
authors.forename: Jacques
authors.initials: J
authors.lastname: Duranteau
mesh_terms: D004636:Emergency Service, Hospital; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015601:Injury Severity Score; D009102:Multiple Organ Failure; D018482:Muscle, Skeletal / Q000098:blood supply / Q000378:metabolism*; D010100:Oxygen / Q000097:blood*; D011446:Prospective Studies; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000097:blood / Q000401:mortality / Q000628:therapy*; D019265:Spectroscopy, Near-Infrared; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D010100:Oxygen