Searching for non-invasive markers of tissue hypoxia 英文参考文献.docVIP

Available online /content/11/1/116 Commentary Searching for non-invasive markers of tissue hypoxia Juan Carlos Puyana1 and Michael R Pinsky2 1Associate Professor of Surgery and Critical Care, Director Applied Research IMITs Center, Innovative Medical Information Technology Center, UPMC, F1265 Presbyterian, 200 Lothrop Street, Pittsburgh, PA 15213-2536, USA 2Professor of Critical Care Medicine, Bioengineering and Anesthesiology, 606 Scaife Hall 3550 Terrace Street, Pittsburgh, PA 15261, USA Corresponding author: Michael R Pinsky, pinskymr@ Published: 23 February 2007 Critical Care 2007, 11:116 (doi:10.1186/cc5691) This article is online at /content/11/1/116 ? 2007 BioMed Central Ltd See related research by Podbregar and Mozina, /content/11/1/R6 Abstract effective resuscitation, as documented by the poorer outcomes for SvO2-guided therapy in patients with Tissue hypoxia is a common end product of circulatory shock and a primary target for resuscitation efforts. In this issue Podbregar and Mozina show that thenar tissue O saturation (StO ) and mixed established shock [3,4]. Recently, however, early goal- directed therapy in patients with sepsis presenting to an emergency department improves outcome when central venous O2 saturation is used as one of the endpoints of resuscitation [5]. Still, neither SvO2 nor central venous O2 provide any insight on the state of oxygen utilization in tissues. 2 2 venous O2 saturation (SvO ) co-vary in patients in left ventricular 2 failure, but in patients with sepsis StO2 was higher than SvO . 2 Although StO2 may co-vary with SvO they have different deter- 2 minants such that after shock StO may increase well before SvO 2 2 as a result of increased O demands to repay O debt incurred 2 2 during hypoperfusion. Thus, the use of StO alone to define the 2 endpoint of resuscitation may be misleading. The relationship between StO2