Thinking Out-of-the-Box: A Non-Standard Application of Standard Pulse-Oximetry and Standard Near-Infrared Spectroscopy in a COVID-19 Patient.
J Intensive Care Med
; 36(3): 376-380, 2021 Mar.
Article
in English
| MEDLINE | ID: covidwho-841807
ABSTRACT
PURPOSE:
Purpose of this report is to describe the feasibility of lingual pulse oximetry and lingual near-infrared spectroscopy (NIRS) in a COVID-19 patient to assess lingual tissue viability after several days of mechanical ventilation in the prone position. MATERIALS &METHODS:
In a COVID-19 ICU-patient, the tongue became grotesquely swollen, hardened and protruding from the oral cavity after 20 h of mechanical ventilation uninterrupted in the prone position. To assess the doubtful viability of the tongue, pulse-oximetric hemoglobin O2-saturation (SpO2; Nellcor, OxiMax MAX-NI, Covidien, MA, USA) and NIRS-based, regional tissue O2-saturation measurements (rSO2; SenSmart, Nonin, MN, USA) were performed at the tongue.RESULTS:
At the tongue, regular pulse-oximetric waveforms with a pulse-oximetric hemoglobin O2-saturation (SpO2) of 88% were recorded, i.e. only slightly lower than the SpO2 reading at the extremities at that time (90%). Lingual NIRS-based rSO2 measurements yielded stable tissue rSO2-values of 76-78%, i.e. values expected also in other adequately perfused and oxygenated (muscle-) tissues.CONCLUSION:
Despite the alarming, clinical finding of a grotesquely swollen, rubber-hard tongue and clinical concerns on the adequacy of the tongue perfusion and oxygenation, our measurements of both arterial pulsatility (SpO2) and NIRS-based tissue oxygenation (rSO2) suggested adequate perfusion and oxygenation of the tongue, rendering non-vitality of the tongue, e.g. by lingual venous thrombosis, unlikely. To our knowledge, this is the first clinical report of lingual rSO2 measurement.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Tongue
/
Tongue Diseases
/
Pulsatile Flow
/
Oximetry
/
Spectroscopy, Near-Infrared
/
Edema
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
J Intensive Care Med
Journal subject:
Critical Care
Year:
2021
Document Type:
Article
Affiliation country:
0885066620965167
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