RESUMO
Clinical signs of recovery, such as blood pressure or heart rate, do not accurately reflect the perfusion of organs and tissues in patients in critical condition. Of the various means for monitoring perfusion, regional monitors are the most sensitive. Near-infrared spectroscopy (NIRS), which analyzes infrared light detected after it has passed through red blood cells in tissues, provides a measure of oxygen saturation that is the most appropriate method for clinical situations. In patients with sepsis or multiple injuries, tissue oxygen saturation can be useful as an early indicator of shock, as a marker of recovery or need for transfusion, or as a prognostic factor. In spite of widespread interest in NIRS, however, there are gaps to fill in our understanding of clinical signs and physiology in relation to this technique before peripheral tissue monitoring can become routine in postanesthesia recovery care units.
Assuntos
Período de Recuperação da Anestesia , Microcirculação , Monitorização Fisiológica/métodos , Consumo de Oxigênio , Oxiemoglobinas/análise , Complicações Pós-Operatórias/prevenção & controle , Sala de Recuperação , Choque/prevenção & controle , Espectroscopia de Luz Próxima ao Infravermelho , Dióxido de Carbono/sangue , Hipóxia Celular , Ensaios Clínicos como Assunto , Sistemas Computacionais , Diagnóstico Precoce , Humanos , Manometria , Monitorização Fisiológica/instrumentação , Traumatismo Múltiplo/sangue , Traumatismo Múltiplo/fisiopatologia , Oxigênio/sangue , Pressão Parcial , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/fisiopatologia , Choque/sangue , Choque/diagnóstico , Choque/fisiopatologia , Choque Séptico/sangue , Choque Séptico/fisiopatologia , Espectroscopia de Luz Próxima ao Infravermelho/métodosRESUMO
Los parámetros clínicos de reanimación como la presiónarterial, la frecuencia cardíaca etc. son insuficientespara garantizar la correcta perfusión de los tejidos yórganos del paciente en estado crítico. Diferentes monitoresevalúan la correcta perfusión, de ellos los más sensiblesson los monitores de perfusión regional. Las tecnologíaNIRS (Near Infrared Spectroscopy), basada en elanálisis de la luz infrarroja recaptada tras incidir sobrelas moléculas de hemoglobina del tejido y así determinarsu saturación, destaca por ser la técnica regional másadecuada para uso clínico. En el paciente politraumatizadoy séptico la saturación tisular de O2 puede resultarútil en la detección precoz del shock, como parámetrodiana de la reanimación, como marcador transfusional ycomo factor pronóstico. A pesar del interés por la tecnologíaNIRS se deberán realizar estudios que llenenlagunas existentes a nivel clínico y fisiológico para quela monitorización de la perfusión tisular se convierta enmonitor rutinario en nuestras áreas de reanimación(AU)
Clinical signs of recovery, such as blood pressure orheart rate, do not accurately reflect the perfusion oforgans and tissues in patients in critical condition. Of thevarious means for monitoring perfusion, regionalmonitors are the most sensitive. Near-infraredspectroscopy (NIRS), which analyzes infrared lightdetected after it has passed through red blood cells intissues, provides a measure of oxygen saturation that isthe most appropriate method for clinical situations. Inpatients with sepsis or multiple injuries, tissue oxygensaturation can be useful as an early indicator of shock, asa marker of recovery or need for transfusion, or as aprognostic factor. In spite of widespread interest in NIRS,however, there are gaps to fill in our understanding ofclinical signs and physiology in relation to this techniquebefore peripheral tissue monitoring can become routinein postanesthesia recovery care units(AU)
