Is tissue oxygen saturation related with complete blood parameters in ED patients?

Abstract

word count: Text word count: Complete blood count (CBC) is an easy analysis that is usually overlooked by clinicians, and parameters of CBC may provide to make a prediction about the patient’s clinical status, related with the illness [1]. Mean platelet volume (MPV) is an indicator of the size distribution of platelets. The MPV is directly correlated with the rate of platelet production [2]. Near-infrared spectroscopy (NIRS) allows noninvasive measurement of tissue oxygen saturation (StO2) [3,4], and literature has reported that it can be useful in determining the AC C EP TE D M AN U SC R IP T ACCEPTED MANUSCRIPT severity of hemorrhagic shock [5], fluid resuscitation [6], septic shock [7], and predicting multiple-organ dysfunction syndrome [8]. But there is a lack of data on it’s use in emergency practice [9]. To the best of our knowledge, no research has been peformed to date for evaluation of the relationship StO2 levels and CBC parameters in the emergency department (ED). The aim of the present study was to determine the relationship between StO2 levels and CBC parameters of ED patients. Approval of the Human Study Committee of our medical faculty was provided for this study. The participants/relatives were informed and gave their informed consent. We examined 130 patients who were admitted to our ED and underwent laboratory evaluation. Age, gender, and CBC parameters including white blood cell count (WBC), hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), red cell distribution width (RDW), platelet (Plt), and MPV levels of the patients were noted. For the StO2 level measurement, an InSpectra device was placed to the right thenar muscle for 10 s and means of the first, fifth and 10th second values were noted at the time of admission. In our study, we measured thenar muscle StO2 via wide-gap second-derivative NIRS (InSpectra; Hutchinson Technology). Cardiopulmonary arrest patients and patients under age 18 were excluded from the study. The normal distribution and homogeneity of each parameter were tested using the Shapiro– Wilk test and the Kolmogorov–Smirnov test. Age and StO2 values did not suit the normal distribution. A Mann Whitney-U test was used for differences between and among the two groups. A Spearman correlation test was used for correlation analysis. In all tests the significance level was p<0.05. SPSS (Statistical Package for the Social Sciences) software 20.0 was used for analysis. In our study 66 (50.8%) female, 66 (48.2%) male total 130 patients were included. Mean age of our study group was 47.75±18.91 (min:18, max:80). The mean StO2 level of females was 80.52±5.89 (min:67,max:92) and mean StO2 level of males was 78.50±6.53 (min:62,max: 93). Mean StO2 values of the genders were significantly different (p=0.02). StO2 levels were correlated with Hct (p=0.032, r=0.189) and MPV( p=0.016, r=-0.211) levels. Detailed correlations between Sto2 and age, WBC, Hct, MCV, Plt, MPV and RDW according to gender are given in Table 1. StO2 values are correlated with Hct and MPV levels. StO2 level measurement may be helpful in predicting the Hct and MPV values of the ED patients. AC C EP TE D M AN U SC R IP T ACCEPTED MANUSCRIPT