Assessment of macro- and micro-oxygenation parameters during fractional fluid infusion: A pilot study.

Abstract

PURPOSE The main goal of this study was to assess whether maximal fluid infusion improves both oxygen delivery (DO2) and micro-circulatory parameters during hemodilution. The secondary objective was to assess the ability of baseline micro-circulatory parameters to predict oxygen consumption (VO2) response following fluid infusion. MATERIALS AND METHODS In a postoperative cardiac ICU, patients received repeated fluid infusion until stroke volume (SV) was maximized. Before and after each fluid expansion, macro- (DO2, VO2) and micro-circulatory oxygenation parameters were recorded [central venous oxygen saturation (ScVO2), blood lactate, difference in veno-arterial carbon dioxide tension (P(v-a)CO2), somatic and cerebral oxygen saturation (rSO2)]. Patients were classified as VO2-Responders or VO2-Non-Responders according to an increase in VO2 above or below 15%, respectively. RESULTS After maximal fluid infusion, all patients showed improved macro- and micro-circulatory oxygenation parameters, but VO2-Responders had lower values (especially for ScVO2 and cerebral rSO2). Only baseline ScVO2 and cerebral rSO2 were useful to predict the VO2 response to maximal fluid infusion (ROCAUC 0.80 (95% CI: 0.54-0.95, P=0.012) and 0.83 (95% CI: 0.57-0.96, P=0.001). CONCLUSIONS Maximal fluid infusion improves macro- and micro-circulatory oxygenation parameters. For VO2-Responders, only ScVO2 and cerebral rSO2 could serve as markers of tissue hypoxia.

DOI: 10.1016/j.jcrc.2017.03.021

Cite this paper

@article{Fischer2017AssessmentOM, title={Assessment of macro- and micro-oxygenation parameters during fractional fluid infusion: A pilot study.}, author={Marc Olivier Fischer and Vincent Bonnet and Emmanuel F. Lorne and J Y Lefrant and Olivier Rebet and Beno{\^i}t Courteille and Charlotte Lem{\'e}tayer and J-J Parienti and Jean-louis Gerard and J. L. Fellahi and Jean - Luc Hanouz}, journal={Journal of critical care}, year={2017}, volume={40}, pages={91-98} }