Do cerebral and somatic tissue oxygen saturation measurements correlate with each other during surgery?

Abstract Background: Intraoperative cerebral desaturations have been associated with worse neurological outcomes after supine surgery. However, it is not clear whether intraoperative somatic tissue oxygenation is more associated with postoperative cognitive dysfunction (POCD) than cerebral oxygenation in patients with hypertension after prone spine surgery.Methods: Patients with hypertension scheduled for spine open surgery were included from 2020 to 2021 in a single-center, prospective, observational study. Baseline both cerebral and somatic tissue oxygen saturation were measured in operating room before surgery. Cerebral and somatic tissue oxygen saturations were monitored continuously throughout surgery. The presence of POCD was assessed using the Mini-Mental Status Examination (MMSE). Association with POCD was evaluated with unadjusted analyses and multivariable logistic regression.Results: One hundred and one of 112 patients were included, and 28 (27.8%) developed POCD. None of the investigated SctO2 variables was predictive of POCD. On the contrary, the patients with POCD had a higher decrease in intraoperative absolute SstO2 decrease and relative SstO2 decrease compared with the patients without POCD (4.9%±3.8% vs. 3.6%±2.6%, P=0.037; 7.4%±5.6% vs. 5.3%±3.8%, P=0.036; respectively). Finally, three SstO2 parameters respectively were associated with POCD, including a higher absolute SstO2 decrease (OR, 1.223; 95%CI, 1.031-1.451; P=0.021), a higher absolute SstO2 decrease (OR, 1.138; 95%CI, 1.011-1.281; P=0.032) and falling below 90% of baseline SstO2 (OR, 11.388; 95%CI, 2.367-54.785; P=0.002), independent of ASA III, preoperative platelet and postoperative sepsis. Conclusions: Twenty-eight (27.8%) of 101patients developed POCD. Somatic tissue oxygenation has a stronger association with POCD than cerebral tissue oxygenation after spine open surgery in patients with hypertension.Clinical trial registration: ChiCTR1900028392. Registered 20 December 2019.

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Faculty Opinions recommendation of Changes in cerebral tissue oxygen saturation during anaesthetic-induced hypotension: an interpretation based on neurovascular coupling and cerebral autoregulation.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718004161.793475754 ◽

2013 ◽

Author(s):

Luzius A Steiner

Keyword(s):

Oxygen Saturation ◽

Cerebral Autoregulation ◽

Neurovascular Coupling ◽

Tissue Oxygen Saturation ◽

Tissue Oxygen ◽

Cerebral Tissue ◽

Induced Hypotension ◽

Cerebral Tissue Oxygen Saturation

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Quantifying dermal microcirculatory changes of neuropathic and neuroischemic diabetic foot ulcers using spatial frequency domain imaging: a shade of things to come?

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2020-001815 ◽

2020 ◽

Vol 8 (2) ◽

pp. e001815

Author(s):

Grant A Murphy ◽

Rajinder P Singh-Moon ◽

Amaan Mazhar ◽

David J Cuccia ◽

Vincent L Rowe ◽

...

Keyword(s):

Diabetes Mellitus ◽

Spatial Frequency ◽

Oxygen Saturation ◽

Diabetic Foot ◽

Clinical Course ◽

Tissue Oxygen Saturation ◽

Tissue Oxygen ◽

Spatial Frequency Domain Imaging ◽

Patients With Diabetes ◽

Spatial Frequency Domain

IntroductionThe use of non-invasive vascular and perfusion diagnostics are an important part of assessing lower extremity ulceration and amputation risk in patients with diabetes mellitus. Methods for detecting impaired microvascular vasodilatory function in patients with diabetes may have the potential to identify sites at risk of ulceration prior to clinically identifiable signs. Spatial frequency domain imaging (SFDI) uses patterned near-infrared and visible light spectroscopy to determine tissue oxygen saturation and hemoglobin distribution within the superficial and deep dermis, showing distinct microcirculatory and oxygenation changes that occur prior to neuropathic and neuroischemic ulceration.Research designs and methods35 patients with diabetes mellitus and a history of diabetic foot ulceration were recruited for monthly imaging with SFDI. Two patients who ulcerated during the year-long longitudinal study were selected for presentation of their clinical course alongside the dermal microcirculation biomarkers from SFDI.ResultsPatient 1 developed a neuropathic ulcer portended by a focal increase in tissue oxygen saturation and decrease in superficial papillary hemoglobin concentration 3 months prior. Patient 2 developed bilateral neuroischemic ulcers showing decreased tissue oxygen saturation and increased superficial papillary and deep dermal reticular hemoglobin concentrations.ConclusionsWounds of different etiology show unique dermal microcirculatory changes prior to gross ulceration. Before predictive models can be developed from SFDI, biomarker data must be correlated with the clinical course of patients who ulcerate while being followed longitudinally.Trial registration numberNCT03341559.

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