Diffuse reflectance spectroscopy: Systemic and microvascular oxygen saturation is linearly correlated and hypoxia leads to increased spatial heterogeneity of microvascular saturation

Abstract

The microvascular oxygen saturation (SmvO 2) in the skin and tongue (sublingual mucosa) in pigs (n = 6) was characterised using diffuse reflectance spectroscopy (DRS). The correlation between arterial oxygen saturation (SaO 2) and SmvO 2 as well as the spatial heterogeneity of SmvO 2 was examined during hypoxia. DRS uses shallow-penetrating visible light to assess microvascular oxygen saturation (SmvO 2) in superficial tissue. Hypoxia was induced by gradual reduction in ventilation or reduction of the inspiratory oxygen fraction. The spatial heterogeneity of SmvO 2 was expressed as the coefficient of variation (CV) of repeated SmvO 2 measurements. Baseline SmvO 2 before interventions was 20.2% (10.3%–38.1%, median with range) in groin skin, 32.9% (13.0%–49.3%) in the ear and 42.2% (32.1%–51.5%) in the tongue. SmvO 2 in the groin was significantly lower than venous oxygen saturation (SvO 2) (p < 0.05) and SmvO 2 in the tongue ( p = 0.03). There was a significant linear correlation between SaO 2 and SmvO 2 in all measuring sites for both interventions (p < 0.05). Similarly there was a significant correlation between CV of repeated SmvO 2 measurements and SmvO 2 in all measuring sites for both interventions (p < 0.01). The results from baseline measurements indicate a surprisingly high oxygen extraction in the measurement volume of DRS, especially in the groin skin. A reduction of SmvO 2 with decreasing SaO 2 was found and additionally the results suggest that spatial heterogeneity of microvascular oxygen saturation increases during hypoxia. Microvascular disturbances have been demonstrated in both local vascular diseases and systemic conditions such as shock and sepsis, an assessment of microvascular oxygen saturation using DRS may be useful in the monitoring of the microcirculation in such patients. This study is a part of an ongoing characterization of the DRS technique.