Near-infrared spectroscopy-derived tissue oxygen saturation in battlefield injuries: a case series report

BACKGROUND: Near-infrared spectroscopy technology has been utilized to monitor perfusion status in animal models of hemorrhagic shock and in human traumatic injury. To observe the effectiveness of such a device in a combat setting, an FDA-approved device was used in conjunction with standard resuscitation and therapy of wounded patients presenting to the 228(th )Combat Support Hospital (CSH), Company B, over a three-month period. MATERIALS AND METHODS: These observations were performed on patients presenting to the 228(th )CSH, Co B, at Forward Operating Base Speicher, outside of Tikrit, Iraq, between the dates of June 15 and September 11, 2005. We utilized the Inspectra™ 325 tissue oxygen saturation (StO(2)) monitor (Hutchinson Technology, Inc; Hutchinson, MN, USA) with the probe placed on the thenar eminence or on another appropriate muscle bed, and used to monitor StO(2 )during early resuscitation and stabilization of patients. RESULTS: During the above time period, 161 patients were evaluated at the CSH as a result of traumatic injury and the device was placed on approximately 40 patients. In most patients, StO(2 )readings of greater than 70% were noted during the initial evaluation. No further information was collected from these patients. In 8 patients, convenience samples of StO(2 )data were collected along with pertinent physiologic data. In these patients, StO(2 )levels of below 70% tracked with hypotension, tachycardia, and clinical shock resulted in increases in StO(2 )after resuscitation maneuvers. CONCLUSION: Near-infrared spectroscopy-derived StO(2 )reflected and tracked the resuscitation status of our patients with battlefield injuries. StO(2 )has significant potential for use in resuscitation and care of patients with battlefield injuries.