Near Infrared Spectroscopy (NIRS) in Severe Sepsis
Near Infrared Spectroscopy (NIRS) in Severe Sepsis
The purpose of this study is to evaluate the usefulness of an optimization of muscle
 perfusion and oxygenation, as assessed by the NIRS technique, in critically ill patients with
 sepsis.
The systemic inflammatory response to sepsis may cause impaired tissue oxygenation that can
 persist despite the restoration of a normal hemodynamic profile and systemic oxygen
 transport.

 Therefore, the assessment of tissue oxygenation and perfusion is recommended in patients with
 severe sepsis.

 The InSpectra tissue spectrometer relies on continuous wave near infrared (NIR) technology to
 estimate non invasively local tissue hemoglobin oxygen saturation in tissue (% StO2). This
 technology had been tested in a variety of systems: standard theoretical models of light
 transport, isolated blood, isolated blood-perfused animal organs and healthy human volunteers
 with induced limb ischemia. In critical-care medicine, NIRS has also been used to evaluate
 muscle oxygenation in trauma resuscitation and in lower extremity and abdominal compartment
 syndrome. However, NIRS has been rarely utilised to measure tissue blood flow and oxygen
 uptake in critically ill patients.
Inclusion Criteria:

 -  Two of four criteria for the systemic inflammatory response syndrome; and one of the
 following:

 -  systolic blood pressure =< 90 mm Hg; or

 -  a blood lactate concentration => 4 mmol/l; or

 -  skin marbling; or

 -  impaired consciousness; or

 -  urine output < 30 ml/h.

 Exclusion Criteria:

 -  Age < 18 years

 -  Pregnancy

 -  Do-not-resuscitate status

 -  Advanced directives restricting implementation of the protocol

 -  Obesity (body mass index [BMI] > 30)

 -  Anasarca