Postoperative Monitoring of Free DIEP Flap in Breast Reconstruction with Near-Infrared Spectroscopy: Variables Affecting the Regional Oxygen Saturation

2018 ◽  
Vol 34 (06) ◽  
pp. 383-388 ◽  
Author(s):  
Marzia Salgarello ◽  
Domenico Pagliara ◽  
Marco Rossi ◽  
Giuseppe Visconti ◽  
Liliana Barone-Adesi
Keyword(s):  
Infrared Spectroscopy ◽  
Breast Reconstruction ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Free Flap ◽  
Linear Correlation ◽  
Near Infrared ◽  
Skin Flap ◽  
Diep Flap ◽  
Negative Linear Correlation

Background The timing of surgical reexploration in microanastomotic thrombosis is directly related to the salvage rate of free flap. Near-infrared spectroscopy (NIRS) is a noninvasive technique, which allows a continuous bedside monitoring of flap oxygenation. The current literature is lacking in the assessment of variables able to modify the NIRS monitoring. The aim of this study is to identify patient and flap-related variables that can affect regional oxygen saturation (rSO2). Methods We retrospectively analyzed the data obtained from 45 consecutive patients undergoing breast reconstruction with deep inferior epigastric perforator (DIEP) flap. The monitoring device used is the Somanetics INVOS 5100C Cerebral/Somatic Oximeter (Covidien). Baseline measures of demographic–anthropometric variables (age, weight, height, body mass index [BMI]) and flap factors (flap size in grams, skin flap area in square centimeters, perforator number, and perforator size in millimeters) were collected from preoperative and intraoperative assessment. We investigated the linear correlation between mean rSO2 and BMI, flap size, skin flap area, perforator number, and perforator size. Results A positive linear correlation between rSO2 values and skin flap area, perforator number, and perforator size was found. A negative linear correlation between rSO2 values and BMI and flap size was found. All correlations are statistically significant. Despite the overall negative linear correlation between rSO2 values and flap size, we observed a bimodal trend: a positive relation up to 800 g, which is inverted above 800 g. Conclusion The NIRS is a reliable additional tool in free flap monitoring. A careful evaluation should be given to patients and surgery factors that can change the oximetry data.

Near-Infrared Spectroscopy Monitoring of Cerebral Oxygenation and Influencing Factors in Neonates from High-Altitude Areas

Neonatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Bi Ze ◽  
Lili Liu ◽  
Ge Sang Yang Jin ◽  
Minna Shan ◽  
Yuehang Geng ◽  
...  
Keyword(s):  
Heart Disease ◽  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Low Altitude ◽  
Normal Neonates

<b><i>Background:</i></b> Accurate detection of cerebral oxygen saturation (rSO<sub>2</sub>) may be useful for neonatal brain injury prevention, and the normal range of rSO<sub>2</sub> of neonates at high altitude remained unclear. <b><i>Objective:</i></b> To compare cerebral rSO<sub>2</sub> and cerebral fractional tissue oxygen extraction (cFTOE) at high-altitude and low-altitude areas in healthy neonates and neonates with underlying diseases. <b><i>Methods:</i></b> 515 neonates from low-altitude areas and 151 from Tibet were enrolled. These neonates were assigned into the normal group, hypoxic-ischemic encephalopathy (HIE) group, and other diseases group. Near-infrared spectroscopy was used to measure rSO<sub>2</sub> in neonates within 24 h after admission. The differences of rSO<sub>2</sub>, pulse oxygen saturation (SpO<sub>2</sub>), and cFTOE levels were compared between neonates from low- and high-altitude areas. <b><i>Results:</i></b> (1) The mean rSO<sub>2</sub> and cFTOE levels in normal neonates from Tibet were 55.0 ± 6.4% and 32.6 ± 8.5%, significantly lower than those from low-altitude areas (<i>p</i> &#x3c; 0.05). (2) At high altitude, neonates with HIE, pneumonia (<i>p</i> &#x3c; 0.05), anemia, and congenital heart disease (<i>p</i> &#x3c; 0.05) have higher cFTOE than healthy neonates. (3) Compared with HIE neonates from plain areas, neonates with HIE at higher altitude had lower cFTOE (<i>p</i> &#x3c; 0.05), while neonates with heart disease in plateau areas had higher cFTOE than those in plain areas (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The rSO<sub>2</sub> and cFTOE levels in normal neonates from high-altitude areas are lower than neonates from the low-altitude areas. Lower cFTOE is possibly because of an increase in blood flow to the brain, and this may be adversely affected by disease states which may increase the risk of brain injury.

scholarly journals Near-infrared spectroscopy monitoring tissue oxygen saturation after cardiac surgery

Critical Care ◽  
2009 ◽  
Vol 13 (Suppl 1) ◽  
pp. P239
Author(s):  
R Kopp ◽  
S Rex ◽  
K Dommann ◽  
G Schälte ◽  
G Dohmen ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Tissue Oxygen Saturation ◽  
Tissue Oxygen

scholarly journals The effects of ultrasound and shockwave treatment on muscle regional oxygen saturation using near-infrared spectroscopy

2018 ◽  
Vol 64 (3) ◽  
Author(s):  
Anna Lubkowska ◽  
Aleksandra Radecka ◽  
Miłosz Parchimowicz ◽  
Iwona Bryczkowska ◽  
Monika Chudecka
Keyword(s):  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Ultrasound Therapy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Regional Oxygen Saturation ◽  
Shockwave Therapy

ABSTRAKTWstęp: Terapeutyczne fale ciśnieniowe są często stosowane w leczeniu różnych schorzeń układu mięśniowo-szkieletowego, niemniej jednak efekt biologiczny ich odziaływania wciąż nie został w pełni poznany. W przedstawionych badaniach oceniono wpływ fal dźwiękowych o różnej sile bodźca stosowanych w terapii falą ultradźwiękową (ultrasound therapy – UST) i pozaustrojową radialną falą uderzeniową (radial extracorporeal shockwave therapy – rESWT) na wysycenie tlenem tkanki mięśniowej i temperaturę powierzchniową w kontekście potencjalnego efektu troficznego przy użyciu spektroskopii bliskiej podczerwieni (near-infrared spectroscopy).Materiały i metody: Badaniem objęto 41 zdrowych ochotników, w tym 27 poddanych UST i 14 rESWT, w wieku 22–48 lat. Pomiar saturacji tkankowej i temperatury powierzchni obszaru mięśnia podgrzebieniowego wykonano 4-krotnie: bezpośrednio przed (T0) i po (T1) oraz 15 (T2) i 30 min po aplikacji bodźca (T3). Saturacje mięśni zmierzono na 2 głębokościach: 20 mm (czujnik 1 – S1) i 12,5 mm (czujnik 2 – S2).Wyniki: Wartość regionalnej perfuzji tkankowej (rSO2 [%]) istotnie zmniejszyła się natychmiast oraz po 15 i 30 min od UST. Wartości początkowe, wynoszące 71,26 ±5,47% (S1) i 88,26 ±2,89% (S2) dla odpowiednich głębokości, znacząco spadły po bodźcowaniu odpowiednio do 68,89 ±5,26% (T2) i 68,93 ±5,12% (T3) na głębokości 20 mm i 86,63 ±5,37% (T1) i 86,52 ±3,38% (T2) na głębokości 12,5 mm.Wnioski: Uzyskane wyniki wskazują, że tylko leczenie za pomocą UST ma znaczący wpływ na zmiany oksymetrii regionalnej, co tłumaczy się ich działaniem przekrwiennym i termicznym w tkankach głębokich, które z kolei indukują dysocjacje tlenu z hemoglobiny do tkanek i efekt troficzny.

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