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Evaluation of Tissue Oxygenation

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Surgical Intensive Care Medicine

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Abstract

The main goal of hemodynamic resuscitation is to preserve and/or restore tissue oxygenation. However, tissue oxygenation in itself is seldom measured in clinical practice due to technical limitations. Indirect measurements such as venous oxygen saturation and lactate levels are more often measured, but these may fail to detect impairment in tissue perfusion. Recent advances in technologies have allowed to detect that microcirculatory alterations are frequently observed in critically ill patients, especially in sepsis. These alterations are characterized by a decrease in capillary density and impaired perfusion in some but not all capillaries, which induce perfusion and oxygenation heterogeneities. This is of particular relevance for monitoring as the device should be able to detect tissue perfusion heterogeneity or its consequences. In this chapter we will describe these alterations and discuss the different techniques that can be used to explore tissue perfusion/oxygenation at bedside.

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Conflicts of Interest

None to be declared.

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Authors and Affiliations

  1. Department of Intensive Care, CHIREC Hospitals, Univerisité Libre de Bruxelles (ULB), 35 rue Wayez, 1420, Braine L’Alleud, Belgium

    Daniel de Backer MD, PhD

  2. Department of Intensive Care, Azienda Ospedaliera UniversitariaIntegrata (AOUI) di Verona, Verona, Italy

    Katia Donadello MD

  3. Dipartimento ad Attività Integrata (DAI) di Emergenza e Terapie Intensive, U.O.C. Anestesia e Rianimazione B, Verona, Italy

    Katia Donadello MD

Authors
  1. Daniel de Backer MD, PhD
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  2. Katia Donadello MD
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Correspondence to Daniel de Backer MD, PhD .

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Editors and Affiliations

  1. Department of Surgical Critical Care; Lahey Hospital and Medical Center, Division of Surgery, Burlington, Massachusetts, USA

    John M. O'Donnell

  2. Surgical Critical Care Medicine, Pr�-Card�o Hospital, Critical Care Medicine, University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil

    Flávio E. Nácul

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de Backer, D., Donadello, K. (2016). Evaluation of Tissue Oxygenation. In: O'Donnell, J., Nácul, F. (eds) Surgical Intensive Care Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-19668-8_8

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  • DOI: https://doi.org/10.1007/978-3-319-19668-8_8

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19667-1

  • Online ISBN: 978-3-319-19668-8

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