title: Evaluation of StO2 tissue perfusion monitoring as a tool to predict the need for lifesaving interventions in trauma patients.
abstract: BACKGROUND
  Hemorrhage remains the leading cause of mortality in preventable trauma deaths. Earlier recognition of hemorrhagic shock decreases the time to implementation of life-saving interventions improves patient survival. The presence of hemorrhagic shock is not always apparent using standard vital signs monitoring, a clinical state referred to as occult shock.
  
  
  METHODS
  This prospective, observational study was performed at Memorial Hermann Hospital in Houston, TX. Prisoners, pregnant women, and patients with burn injuries greater than 20% total body surface area or bilateral upper extremity fractures were excluded. Hutchinson Technologies Spot Check StO2 device was used to measure StO2 values.
  
  
  RESULTS
  StO2 values less than 75% were predictive of the need for blood product transfusions (P < .01) and the need for emergency surgeries. Nearly one-third of patients who presented with a systolic blood pressure 120 mm Hg or more presented with StO2 less than 75% and had a median base deficit of 5 (3 to 6.5).
  
  
  CONCLUSIONS
  Admission StO2 measurements less than 75% predict the need for blood products and emergent surgical procedures and may be used as an adjunct method for identifying shock. StO2 measurements can aid where laboratory values are unavailable.
authors.affiliation: Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA. Electronic address: Catherine.R.Carlile@uth.tmc.edu.
authors.forename: Catherine
authors.initials: C
authors.lastname: Carlile
authors.affiliation: Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Wade
authors.affiliation: Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA.
authors.forename: Mary Sarah
authors.initials: MS
authors.lastname: Baraniuk
authors.affiliation: Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Holcomb
authors.affiliation: Department of Surgery, University of Texas Medical School at Houston, Center for Translational Injury Research (CeTIR), 6410 Fannin Street UPB 1100, Houston, TX, 77030, USA.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Moore
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010100:Oxygen / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000628:therapy*; D019265:Spectroscopy, Near-Infrared; D013781:Texas; D014947:Wounds and Injuries / Q000150:complications*
chemical_list: D010100:Oxygen
keywords: Near-infrared spectroscopy; Occult shock; Perfusion; Shock; Trauma