Near infrared spectroscopy for evaluation of global and skeletal muscle oxygenation in critically ill

Clinicians realize the limitations of the physical examination in detecting compensated shock states, the severity of uncompensated states, and in determining the adequacy of resuscitation in order to prevent subsequent multisystem organ failure and death. This paper will describe the principles of MRS and the basis for its proposed use in the critically ill to assess global and tissue oxygenation. The paper is focused on MRS signal form skeletal muscle during severe heart failurel cardiogenic shock or severe sepsis / septic shock. This paper discuses also limitations of NIRS, current controversies, and what will be needed in the future to make this technology a part of the initial and ongoing assessment ofpatient. The ultimate goal of such techniques is to prevent misassessment of patients and inadequate resuscitation, which are believed to be major initiators in the development of multisystem organ failure and death.