Cara Adler reviewing Reisner AT et al. Acad Emerg Med 2016 Feb 29.

Adding muscle oxygen saturation to vital signs improved identification of patients requiring transfusion of 3 or more units of red blood cells.

Researchers assessed whether the addition of muscle oxygen saturation (SmO2) to vital signs improves early (before other diagnostic tests are available) identification of trauma patients with major hemorrhage. In an observational study at a Level I trauma center, the researchers analyzed mean muscle oxygen saturation (monitored with near-infrared spectrometry [NIRS]), heart rate, pulse pressure, and systolic blood pressure monitored over a 10-minute period early in patients' emergency department evaluation.

Of 487 adult patients (68% men) enrolled over a 2-year span, 23 received 3 or more units of red blood cells within 24 hours (primary outcome) and 11 received 9 or more units. In multivariate regression models, addition of SmO2 to the vital signs significantly increased prediction of patients who received 3 or more units (area under the receiver operating characteristic curve, 0.77 without SmO2 vs. 0.85 with SmO2). Results were similar for prediction of patients who received 9 or more units.

Citation(s):

Reisner AT et al. Muscle oxygen saturation improves diagnostic association between initial vital signs and major hemorrhage: A prospective observational study. Acad Emerg Med 2016 Feb 29; [e-pub].

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