This work examines tissue oxygenation (StO2), as measured by near infrared spectroscopy (NIRS), as tool for assessing trauma patients, with particular emphasis on its use in the deployed military environment. Resting StO2 values were examined and found to vary significantly between monitoring sites. Exercise was associated with a significant increase in StO2. Comparing the sensitivities of different NIRS monitoring sites in detecting simulated hypovolaemia, the forearm and deltoid were found be the most sensitive sites. The thenar eminence and brain were not sensitive to mild degrees of hypovolaemia. The administration of morphine was found to attenuate the StO2 response to hypovolaemia at all sites. In a porcine trauma model changes in StO2 recorded from both injured and uninjured muscle sites phase led those of base excess and lactate by 31–37 minutes, and demonstrate that injured monitoring sites can be used to accurately track patients’ response to resuscitation. In the deployed military setting NIRS was found to be a robust, easy to use technique for the initial assessment of patients. Although StO2 was not demonstrable superior to a combination of pulse rate and blood pressure it has several practical advantages that make it a useful adjunct to contemporary trauma care.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:687508 |
| Date | January 2016 |
| Creators | Barker, Tom |
| Publisher | University of Birmingham |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://etheses.bham.ac.uk//id/eprint/6732/ |
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