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Master Thesis

Évaluation de la StO2 musculaire au cours de la phase précoce d'une assistance circulatoire‎ = Assessment of muscle StO2 in the early phase of extracorporeal life support

Abstract : Patients who have a extracorporeal life support (ECLS) for severe cardiogenic shock are at high risk of hypoperfusion leading to multiple organ dysfunction even though the device restores the macrohemodynamics. The informativeness of NIRS technology for patients under an ECMO device has not been established. After the local ethics commitee approval, patients had an ECMO devise implanted for cardiogenic shock refractory to medical treatment, with or without prior cardiac arrest. StO2 was measured on the thenar eminence by the Inspectra™ device (Hutchinson Technology, USA) during the first 48 hours. A vascular occlusive test on the arm by an arterial occlusion with 50 mmhg over the systolic pressure with a sphygmomanometer cuff during 3 min was performed at H2, H12, H24, H48. 25 patients were included. 8 patients had died by day 7. StO2 had no time evolution. Desaturation slopes and resaturation slopes increase with time under ECMO (p<0,05). Resaturation slopes was significally lower at H24 and H48 for the non-survivors vs survivors (p<0,05). No significant correlation has been observed beetween StO2 and ScVO2. In this limited cohort, one finds that even if patient are under an ECMO device and a non-pulsatile flow, the desaturation, indirect parameter for muscle oxygen consumption, and the resaturation slope, reflecting the capacities of capillary recruitment, have improved under ECMO. StO2 does not seem to bring any information but the VOT parameters seem to discriminate over time non-survivors. The resaturation slope could be a novel tool to better estimate the microvascular dysfunction and could be use to optimise the microperfusion for patients under ECMO.
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Master Thesis
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Submitted on : Thursday, May 17, 2012 - 5:47:51 PM
Last modification on : Tuesday, May 11, 2021 - 11:36:16 AM
Long-term archiving on: : Friday, December 9, 2011 - 2:21:54 AM

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  • HAL Id : dumas-00620668, version 1

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Serge Hautefeuille. Évaluation de la StO2 musculaire au cours de la phase précoce d'une assistance circulatoire‎ = Assessment of muscle StO2 in the early phase of extracorporeal life support. Médecine humaine et pathologie. 2011. ⟨dumas-00620668⟩

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