Commenced in January 2007
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Pulse Oximeter Concept for Vascular Occlusion Test

Authors: Fatanah M. Suhaimi, J. Geoffrey Chase, Christopher G. Pretty, Rodney Elliott, Geoffrey M. Shaw


Microcirculatory dysfunction is very common in sepsis and may results in organ failure and increased risk of death. Analyzing oxygen utilization can potentially assess microcirculation function of an individual. In this study, a modified pulse oximeter is used to extract information signals due to absorption of red (R) and infrared (IR) light. IR and R signal are related to the overall blood volume and reduced hemoglobin, respectively. Differences between these two signals thus represent the amount of oxygenated hemoglobin. Avascular occlusion test has been conducted on healthy individuals to validate the pulse oximeter concept. In this test, both R and IR signals rapidly changed according to the occlusion process. The pulse oximeter concept presented is capable of extracting valuable information to assess microcirculation condition. Implementing this concept on ICU patients has the potential to aid sepsis diagnosis and provide more accurate tracking of patient state and sepsis status.

Keywords: Microcirculation, sepsis, sepsis diagnosis, oxygen extraction.

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[1] C. Ince, "The microcirculation is the motor of sepsis," Critical Care, vol. 9, pp. S13-S19, Aug 2005.
[2] P. E. Spronk, D. F. Zandstra, and C. Ince, "Bench-to-bedside review: Sepsis is a disease of the microcirculation," Critical Care, vol. 8, pp. 462-468, Dec 2004.
[3] R. C. Bone, R. A. Balk, F. B. Cerra, R. P. Dellinger, A. M. Fein, W. A. Knaus, R. M. H. Schein, and W. J. Sibbald, "Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis," Chest, vol. 101, pp. 1644-1655, Jun 1992.
[4] M. M. Levy, M. P. Fink, J. C. Marshall, E. Abraham, D. Angus, D. Cook, J. Cohen, S. M. Opal, J. L. Vincent, G. Ramsay, and I. S. D. Conf, "2001 Sccm/Esicm/Accp/Ats/Sis International Sepsis Definitions Conference," Critical Care Medicine, vol. 31, pp. 1250-1256, Apr 2003.
[5] Y. Sakr, M. J. Dubois, D. De Backer, J. Creteur, and J. L. Vincent, "Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock," Crit Care Med, vol. 32, pp. 1825-31, Sep 2004.
[6] C. Ince and M. Sinaasappel, "Microcirculatory oxygenation and shunting in sepsis and shock," Critical Care Medicine, vol. 27, pp. 1369-1377, Jul 1999.
[7] C. Lam, K. Tyml, C. Martin, and W. Sibbald, "Microvascular Perfusion Is Impaired in a Rat Model of Normotensive Sepsis," Journal of Clinical Investigation, vol. 94, pp. 2077-2083, Nov 1994.
[8] C. Bernet, O. Desebbe, S. Bordon, C. Lacroix, P. Rosamel, F. Farhat, J. J. Lehot, and M. Cannesson, "The Impact of Induction of General Anesthesia and a Vascular Occlusion Test on Tissue Oxygen Saturation Derived Parameters in High-Risk Surgical Patients," Journal of Clinical Monitoring and Computing, vol. 25, pp. 237-244, Aug 2011.
[9] R. Bezemer, A. Lima, D. Myers, E. Klijn, M. Heger, P. T. Goedhart, J. Bakker, and C. Ince, "Assessment of tissue oxygen saturation during a vascular occlusion test using near-infrared spectroscopy: the role of probe spacing and measurement site studied in healthy volunteers," Critical Care, vol. 13, 2009.
[10] E. Futier, S. Christophe, E. Robin, A. Petit, B. Pereira, J. Desbordes, J. E. Bazin, and B. Vallet, "Use of near-infrared spectroscopy during a vascular occlusion test to assess the microcirculatory response during fluid challenge," Critical Care, vol. 15, 2011.
[11] H. Gomez, A. Torres, P. Polanco, H. K. Kim, S. Zenker, J. C. Puyana, and M. R. Pinsky, "Use of non-invasive NIRS during a vascular occlusion test to assess dynamic tissue O-2 saturation response," Intensive Care Medicine, vol. 34, pp. 1600-1607, Sep 2008.
[12] C. Mayeur, S. Campard, C. Richard, and J. L. Teboul, "Comparison of four different vascular occlusion tests for assessing reactive hyperemia using near-infrared spectroscopy," Critical Care Medicine, vol. 39, pp. 695-701, Apr 2011.
[13] W. N. Colier, I. B. Meeuwsen, H. Degens, and B. Oeseburg, "Determination of oxygen consumption in muscle during exercise using near infrared spectroscopy," Acta Anaesthesiol Scand Suppl, vol. 107, pp. 151-5, 1995.
[14] J. Creteur, T. Carollo, G. Soldati, G. Buchele, D. De Backer, and J. L. Vincent, "The prognostic value of muscle StO(2) in septic patients," Intensive Care Medicine, vol. 33, pp. 1549-1556, Sep 2007.
[15] K. C. Doerschug, A. S. Delsing, G. A. Schmidt, and W. G. Haynes, "Impairments in microvascular reactivity are related to organ failure in human sepsis," American Journal of Physiology-Heart and Circulatory Physiology, vol. 293, pp. H1065-H1071, Aug 2007.
[16] R. Pareznik, R. Knezevic, G. Voga, and M. Podbregar, "Changes in muscle tissue oxygenation during stagnant ischemia in septic patients," Intensive Care Medicine, vol. 32, pp. 87-92, Jan 2006.