Brain tissue oxygenation index measured by near infrared spatially resolved spectroscopy agreed with jugular bulb oxygen saturation in normal pediatric brain: a pilot study

Background Bedside assessments of cerebral oxygenation are sought to monitor cerebral injury in patients undergoing intensive care. Spatially resolved spectroscopy measures tissue oxygenation index (TOI, %) which reflects mixed cerebral arterial and venous oxygenations. We aimed to evaluate arterial and venous components of TOI (cerebral arterial to venous volume ratio [A:V ratio]) in the newborn lamb brain using cerebral arterial and venous blood samples, and to investigate the impact of acute hypoxemia on the A:V ratio and TOI. Method Nine lambs were ventilated with varied inspired oxygen to generate arterial oxygen saturations between 25% and 100%. Cerebral arterial and venous oxygen saturations analyzed using cooximeter of arterial and superior sagittal sinus blood were used to estimate TOI (TOIcox), assuming cerebral A:V ratio of 25:75. TOIcox was compared with the TOI measured by spatially resolved spectroscopy (TOIsrs). Actual cerebral arterial and venous volume fractions were reestimated using TOIsrs = cerebral arterial volume fraction cerebral arterial oxygen saturation + cerebral venous volume fraction*cerebral venous oxygen saturation. Results Median (range) TOIsrs was 48.5% (32.0-64.1%), and TOIcox was 48.4% (13.7-74.4%), and the two were significantly correlated (R = 0.77). The mean difference between TOIsrs and TOIcox was 2.4% (limits of agreement ± 18.1%). The TOIsrs - TOIcox difference varied with oxygen saturations, with TOIsrs higher than TOIcox at low saturations, and lower at high saturations. Cerebral arterial volume fraction was 22.9-27.5% in normoxia and markedly increased in hypoxemia. Conclusion TOI corresponds with cerebral oxygenation. The variable agreement of TOIsrs with TOIcox may reflect changes in cerebral A:V ratio due to arterial oxygenation-related vasoreactivity.

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Abstract 65: Evaluating the Role of Continuously Monitoring Regional Cerebral Oxygen Saturation in Predicting the Return of Spontaneous Circulation in Cardiac Arrest Patients: Does the Use of an Electrocardiogram Alone Provide Adequate Information During Cardiopulmonary Resuscitation?

Circulation ◽

10.1161/circ.130.suppl_2.65 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Hitoshi Kano ◽

Tomoyo Saito ◽

Toshihisa Matsui ◽

Akio Endo ◽

Masaki Nagama ◽

...

Keyword(s):

Cardiac Arrest ◽

Oxygen Saturation ◽

Near Infrared ◽

Tissue Oxygenation ◽

Oxygenation Index ◽

Cerebral Oxygen Saturation ◽

Infrared Light ◽

Cerebral Oxygen ◽

Regional Cerebral Oxygen Saturation ◽

Brain Tissue Oxygenation

During CPR as it is currently administered, treatments are selected from an algorithm derived by monitoring with ECG alone. One of the reasons for this is that no other devices are presently thought to be effective in helping to make treatment determinations. Monitoring of regional cerebral oxygen saturation with near infrared light is non-invasive and provides information on brain tissue oxygenation and hemodynamics. The results of our study suggest that measurements derived from continuously monitoring regional cerebral oxygen saturation during CPR can be considered an effective method of predicting the ROSC in cardiac arrest patients. Methods: In 95 patients with out-of-hospital cardiac arrest, the tissue oxygenation index (TOI) was continuously monitored (NIRO-200NX, Hamamatsu Photonics). We investigated the following parameters with respect to whether or not ROSC was achieved: TOI value at the contact of patients (initial TOI); TOI value just before ROSC (pre-ROSC TOI); and the maximum TOI during CPR (maximum TOI). Results: All the patients monitored received treatment with shocks or drugs and the initial TOI was 35.3±7.3%. For 74 patients who did not achieve ROSC, the maximum TOI was 41.0±7.4%, whereas for 21 patients who did achieve ROSC, the pre-ROSC TOI was 51.3±3.6% and the maximum TOI was 64.3±11.4%. ROSC was not achieved in the patients with maximum TOI below 45%. Conclusion: The pre-ROSC TOI was significantly higher than the maximum TOI in the patients who did not achieve ROSC which suggests the possibility of predicting ROSC by monitoring the increase in TOI. In cases where the TOI remains low, there is a possibility that ROSC should not be expected. In such cases, it may be desirable to attempt to improve the quality of CPR to increase the TOI before delivering shocks or administering drugs.

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Frontal cortical oxygenation changes during gravity-induced loss of consciousness in humans: a near-infrared spatially resolved spectroscopic study

Journal of Applied Physiology ◽

10.1152/japplphysiol.01191.2006 ◽

2007 ◽

Vol 103 (4) ◽

pp. 1326-1331 ◽

Cited By ~ 13

Author(s):

Koichi Kurihara ◽

Azusa Kikukawa ◽

Asao Kobayashi ◽

Toshio Nakadate

Keyword(s):

High Performance ◽

Near Infrared ◽

Cerebral Oxygenation ◽

Oxygenation Index ◽

Loss Of Consciousness ◽

Spatially Resolved ◽

Hemoglobin Saturation ◽

Significant Difference ◽

Concentration Changes ◽

Spatially Resolved Spectroscopy

Gravity (G)-induced loss of consciousness (G-LOC), which is presumably caused by a reduction of cerebral blood flow resulting in a decreased oxygen supply to the brain, is a major threat to pilots of high-performance fighter aircraft. The application of cerebral near-infrared spectroscopy (NIRS) to monitor gravity-induced cerebral oxygenation debt has generated concern over potential sources of extracranial contamination. The recently developed NIR spatially resolved spectroscopy (SRS-NIRS) has been confirmed to provide frontal cortical tissue hemoglobin saturation [tissue oxygenation index (TOI)]. In this study, we monitored the TOI and the standard NIRS measured chromophore concentration changes of oxygenated hemoglobin and deoxygenated hemoglobin in 141 healthy male pilots during various levels of +Gz (head-to-foot inertial forces) exposure to identify the differences between subjects who lose consciousness and those who do not during high +Gz exposure. Subjects were exposed to seven centrifuge profiles, with +Gz levels from 4 to 8 Gz and an onset rate from 0.1 to 6.0 Gz/s. The SRS-NIRS revealed an ∼15% decrease in the TOI in G-LOC. The present study also demonstrated the TOI to be a useful variable to evaluate the effect of the anti-G protection system. However, there was no significant difference found between conditions with and without G-LOC in subjects with terminated G exposure. Further studies that elucidate the mechanism(s) behind the wide variety of individual differences may be needed for a method of G-LOC prediction to be effectively realized.

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Spatially resolved spectroscopy (NIRO-300) does not agree with jugular bulb oxygen saturation in patients undergoing warm bypass surgery

Canadian Journal of Anesthesia/Journal canadien d anesthésie ◽

10.1007/bf03028317 ◽

2001 ◽

Vol 48 (5) ◽

pp. 497-501 ◽

Cited By ~ 34

Author(s):

M. Shaaban Ali ◽

M. Harmer ◽

R. S. Vaughan ◽

J. A. Dunne ◽

I. P. Latto

Keyword(s):

Oxygen Saturation ◽

Bypass Surgery ◽

Jugular Bulb ◽

Spatially Resolved ◽

Spatially Resolved Spectroscopy ◽

Jugular Bulb Oxygen Saturation

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Precision of measurement of cerebral tissue oxygenation index using near-infrared spectroscopy in preterm neonates

Journal of Biomedical Optics ◽

10.1117/1.2357730 ◽

2006 ◽

Vol 11 (5) ◽

pp. 054005 ◽

Cited By ~ 66

Author(s):

Line C. Sorensen ◽

Gorm Greisen

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Tissue Oxygenation ◽

Oxygenation Index ◽

Preterm Neonates ◽

Cerebral Tissue ◽

Tissue Oxygenation Index ◽

Cerebral Tissue Oxygenation

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Near-infrared spectroscopy monitoring during out-of-hospital cardiac arrest: can the initial cerebral tissue oxygenation index predict ROSC?

Emergency Medicine Journal ◽

10.1136/emermed-2018-207533 ◽

2018 ◽

pp. emermed-2018-207533

Author(s):

Jumpei Tsukuda ◽

Shigeki Fujitani ◽

Kenichiro Morisawa ◽

Nobuhiko Shimozawa ◽

Brandon D Lohman ◽

...

Keyword(s):

Cardiac Arrest ◽

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Tissue Oxygenation ◽

Oxygenation Index ◽

Patient Death ◽

Clinical Factor ◽

Tissue Oxygenation Index ◽

Hospital Cardiac Arrest

Study objectivesNear-infrared spectroscopy is a modality that can monitor tissue oxygenation index (TOI) and has potential to evaluate return of spontaneous circulation (ROSC) during cardiopulmonary resuscitation (CPR). This study’s objectives were to evaluate whether TOI could be associated with ROSC and used to help guide the decision to either terminate CPR or proceed to extracorporeal CPR (ECPR).MethodsIn this observational study, we assessed the patients with out-of-hospital cardiac arrest with non-traumatic cause receiving CPR on arrival at our ED between 2013 and 2016. TOI monitoring was discontinued either on CPR termination after ROSC was reached or on patient death. Patients were classified into two groups: ROSC and non-ROSC group.ResultsOut of 141 patients, 24 were excluded and the remaining 117 were classified as follows: ROSC group (n=44) and non-ROSC group (n=73). ROSC group was significantly younger and more likely to have their event witnessed and bystander CPR. ROSC group showed a higher initial TOI than non-ROSC group (60.5%±17.0% vs 37.9%±13.7%: p<0.01). Area under the curve analysis was more accurate with the initial TOI than without it for predicting ROSC (0.88, 95% CI 0.82 to 0.95 vs 0.79, 95% CI 0.70 to 0.87: p<0.01). TOI cut-off value ≥59% appeared to favour survival to hospital discharge whereas TOI ≤24% was associated with non-ROSC.ConclusionsThis study demonstrated an association between higher initial TOI and ROSC. Initial TOI could increase the accuracy of ROSC prognosis and may be a clinical factor in the decision to terminate CPR and select patients who are to proceed to ECPR.

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Non-invasive assessment of tissue oxygenation parameters in diabetic patients foot sole using near infrared spectroscopy

Biomedical Spectroscopy and Imaging ◽

10.3233/bsi-210211 ◽

2021 ◽

pp. 1-10

Author(s):

M. Brindha ◽

N.P. Guhan Seshadri ◽

R. Periyasamy

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Tissue Oxygenation ◽

Oxygenation Index ◽

Diabetic Group ◽

Diabetic Patients ◽

Significant Difference ◽

Tissue Hardness ◽

Tissue Oxygenation Index

Background and Objective: Diabetic problems are more common in the lower extremity and linked with high mortality rate which affects public health system. The present study focused on monitoring the changes in tissue oxygenation concentrations using Near infrared spectroscopy system along with temperature and hardness of the foot tissues. Methods: Control subjects (without diabetes) and diabetic patients without neuropathy were selected for this study and three standard foot risk areas were considered. Standard induced ischemic stimulus was given to assess the response of the designed system and to analyze the changes in oxyhemoglobin and deoxyhemoglobin levels during venous occlusion. Results: Results showed significant differences in the tissue oxygenation index value in all three standard areas where oxygenation value at the foot areas were significantly low ( p < 0.05) in diabetic group as compared to control group. Also, significant difference were found in tissue hardness value when comparing between groups, where the diabetic group had significantly high ( p < 0.05) tissue hardness at area 5 and area 8 as compared to control groups. Conclusion: Therefore, the present study concludes that high tissue hardness had significant effect on tissue oxygenation index that affects vascular circulation and this condition could be assessable using NIRS technique in order to find risky areas at the foot sole.

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