000			04099nam a22005177a 4500
008			231004s20232023 xxu||||| |||| 00| 0 eng d
022			_a0363-5023
024			_a10.1016/j.jhsa.2023.06.012 [doi]
024			_aS0363-5023(23)00326-X [pii]
040			_aOvid MEDLINE(R)
099			_a37498271
245			_aPerformance of Near-Infrared Spectroscopy in Detecting Acute Tourniquet-Induced Upper-Extremity Ischemia Across Different Skin Phenotypes.
251			_aJournal of Hand Surgery - American Volume. 2023 Jul 26
252			_aJ Hand Surg [Am]. 2023 Jul 26
253			_aThe Journal of hand surgery
260			_c2023
260			_fFY2024
260			_p2023 Jul 26
265			_saheadofprint
265			_tPublisher
266			_d2023-10-04
501			_aAvailable in print through MWHC library: 1999 - 2002, Available online from MWHC library: 1995 - present
520			_aCLINICAL RELEVANCE: Although NIRS has utility in tracking tissue oxygenation, variable performance with different skin melanin content raises concerns as to whether different cutoff/threshold levels are needed for different groups, and whether NIRS is reliable for spot checks in acute events. Copyright © 2023 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
520			_aCONCLUSIONS: NIRS can rapidly detect acute onset tissue ischemia in the upper extremity. However, given the lower starting StO2 and smaller total StO2 decrease after tourniquet-induced ischemia for patients with higher skin melanin, using NIRS for clinical detection of acute ischemia may be more challenging in these patients. These inconsistencies may limit use of NIRS clinically for spot identification of ischemia.
520			_aMETHODS: Volunteers underwent tourniquet-induced upper extremity ischemia. Skin color was evaluated by the Fitzpatrick scale (FP, range: I-VI) and the Von Luschan scale (vL, range: 1-36). A NIRS probe was placed on one finger. The tourniquet was inflated to 250 mmHg and perfusion was restricted for 7 minutes, followed by a 10-minute monitored reperfusion period. The percent tissue oxygenation (StO2) was recorded.
520			_aPURPOSE: Diagnosing acute tissue ischemia is challenging, particularly in patients with higher skin melanin content. We investigated whether near-infrared spectroscopy (NIRS) is effective and consistent in detecting upper extremity ischemia across various skin phenotypes.
520			_aRESULTS: A total of 55 volunteers were enrolled (22 self-identified as Caucasian, 21 African American, 7 Asian, 2 Latinx, and 2 Biracial). Average starting and ending StO2 for the cohort was 72.2% and 45.9%, respectively. However, there was variability based on skin melanin content. Increasing vL correlated with lower starting StO2, smaller StO2 decrease, and shorter time to reach ischemic steady state. High skin melanin (FP scale IV-VI) was associated with significantly lower starting StO2 (-7.1%) and shorter time to reach ischemic steady state (-0.3 mins). African Americans had lower starting StO2 (-8.6%) and 7.8% lesser total StO2 decrease than other groups.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aCurtis National Hand Center
651			_aCurtis National Hand Center
651			_aCurtis National Hand Center
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aPlastic Surgery Residency
656			_aPlastic Surgery Residency
657			_aJournal Article
700			_aAbadeer, Andrew _bMGUH _cPlastic Surgery Residency _dMD
700			_aGary, Cyril _bMGUH _cPlastic Surgery Residency _dMD
700			_aGiladi, Aviram M _bCURT
700			_aIskandarova, Aygul _bCURT
700			_aYohe, Gabriel J _bCURT
790			_aAbadeer AI, Gary CS, Giladi AM, Iskandarova A, Yohe GJ
856			_uhttps://dx.doi.org/10.1016/j.jhsa.2023.06.012 _zhttps://dx.doi.org/10.1016/j.jhsa.2023.06.012
942			_cART _dArticle
999			_c13294 _d13294