Blood flow index using near-infrared spectroscopy and indocyanine green as a minimally invasive tool to assess respiratory muscle blood flow in humans

2011 ◽  
Vol 300 (4) ◽  
pp. R984-R992 ◽  
Author(s):  
Jordan A. Guenette ◽  
William R. Henderson ◽  
Paolo B. Dominelli ◽  
Jordan S. Querido ◽  
Penelope M. Brasher ◽  
...  
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Respiratory Muscle ◽  
Near Infrared ◽  
Muscle Blood Flow ◽  
Work Of Breathing ◽  
Respiratory Muscles ◽  
Flow Index ◽  
Arterial Cannulation ◽  
Blood Flow Index

Near-infrared spectroscopy (NIRS) in combination with indocyanine green (ICG) dye has recently been used to measure respiratory muscle blood flow (RMBF) in humans. This method is based on the Fick principle and is determined by measuring ICG in the respiratory muscles using transcutaneous NIRS in relation to the [ICG] in arterial blood as measured using photodensitometry. This method is invasive since it requires arterial cannulation, repeated blood withdrawals, and reinfusions. A less invasive alternative is to calculate a relative measure of blood flow known as the blood flow index (BFI), which is based solely on the NIRS ICG curve, thus negating the need for arterial cannulation. Accordingly, the purpose of this study was to determine whether BFI can be used to measure RMBF at rest and during voluntary isocapnic hyperpnea at 25, 40, 55, and 70% of maximal voluntary ventilation in seven healthy humans. BFI was calculated as the change in maximal [ICG] divided by the rise time of the NIRS-derived ICG curve. Intercostal and sternocleidomastoid muscle BFI were correlated with simultaneously measured work of breathing and electromyography (EMG) data from the same muscles. BFI showed strong relationships with the work of breathing and EMG for both respiratory muscles. The coefficients of determination ( R2) comparing BFI vs. the work of breathing for the intercostal and sternocleidomastoid muscles were 0.887 ( P < 0.001) and 0.863 ( P < 0.001), respectively, whereas the R2 for BFI vs. EMG for the intercostal and sternocleidomastoid muscles were 0.879 ( P < 0.001) and 0.930 ( P < 0.001), respectively. These data suggest that the BFI closely reflects RMBF in conscious humans across a wide range of ventilations and provides a less invasive and less technically demanding alternative to measuring RMBF.

Blood Flow Index Using Near Infrared Spectroscopy and Indocyanine Green Dye as a Minimally Invasive Method for Assessing Respiratory Muscle Blood Flow in Humans

CHEST Journal ◽  
2010 ◽  
Vol 138 (4) ◽  
pp. 917A
Author(s):  
Jordan A. Guenette ◽  
William R. Henderson ◽  
Paolo B. Dominelli ◽  
Jordan S. Querido ◽  
Donald E. Griesdale ◽  
...  
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Minimally Invasive ◽  
Respiratory Muscle ◽  
Near Infrared ◽  
Muscle Blood Flow ◽  
Flow Index ◽  
Indocyanine Green Dye ◽  
Blood Flow Index ◽  
Invasive Method

Human respiratory muscle blood flow measured by near-infrared spectroscopy and indocyanine green

2008 ◽  
Vol 104 (4) ◽  
pp. 1202-1210 ◽  
Author(s):  
Jordan A. Guenette ◽  
Ioannis Vogiatzis ◽  
Spyros Zakynthinos ◽  
Dimitrios Athanasopoulos ◽  
Maria Koskolou ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Output ◽  
Infrared Spectroscopy ◽  
Respiratory Muscle ◽  
Near Infrared ◽  
Vastus Lateralis ◽  
Muscle Blood Flow ◽  
Work Of Breathing ◽  
Dilution Method ◽  
Transdiaphragmatic Pressure

Measurement of respiratory muscle blood flow (RMBF) in humans has important implications for understanding patterns of blood flow distribution during exercise in healthy individuals and those with chronic disease. Previous studies examining RMBF in humans have required invasive methods on anesthetized subjects. To assess RMBF in awake subjects, we applied an indicator-dilution method using near-infrared spectroscopy (NIRS) and the light-absorbing tracer indocyanine green dye (ICG). NIRS optodes were placed on the left seventh intercostal space at the apposition of the costal diaphragm and on an inactive control muscle (vastus lateralis). The primary respiratory muscles within view of the NIRS optodes include the internal and external intercostals. Intravenous bolus injection of ICG allowed for cardiac output (by the conventional dye-dilution method with arterial sampling), RMBF, and vastus lateralis blood flow to be quantified simultaneously. Esophageal and gastric pressures were also measured to calculate the work of breathing and transdiaphragmatic pressure. Measurements were obtained in five conscious humans during both resting breathing and three separate 5-min bouts of constant isocapnic hyperpnea at 27.1 ± 3.2, 56.0 ± 6.1, and 75.9 ± 5.7% of maximum minute ventilation as determined on a previous maximal exercise test. RMBF progressively increased (9.9 ± 0.6, 14.8 ± 2.7, 29.9 ± 5.8, and 50.1 ± 12.5 ml·100 ml−1·min−1, respectively) with increasing levels of ventilation while blood flow to the inactive control muscle remained constant (10.4 ± 1.4, 8.7 ± 0.7, 12.9 ± 1.7, and 12.2 ± 1.8 ml·100 ml−1·min−1, respectively). As ventilation rose, RMBF was closely and significantly correlated with 1) cardiac output ( r = 0.994, P = 0.006), 2) the work of breathing ( r = 0.995, P = 0.005), and 3) transdiaphragmatic pressure ( r = 0.998, P = 0.002). These data suggest that the NIRS-ICG technique provides a feasible and sensitive index of RMBF at different levels of ventilation in humans.

Measurement of Respiratory Muscle Blood Flow in Humans Using Near Infrared Spectroscopy and Indocyanine Green

2008 ◽  
Vol 40 (Supplement) ◽  
pp. S304
Author(s):  
Jordan A. Guenette ◽  
Ioannis Vogiatzis ◽  
Spyros Zakythinos ◽  
Dimitrios Athanasopoulos ◽  
Spyretta Golemati ◽  
...  
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Indocyanine Green ◽  
Near Infrared Spectroscopy ◽  
Respiratory Muscle ◽  
Near Infrared ◽  
Muscle Blood Flow

scholarly journals Near-Infrared Spectroscopy Assessment of Cerebral Oxygen Metabolism in the Developing Premature Brain

2011 ◽  
Vol 32 (3) ◽  
pp. 481-488 ◽  
Author(s):  
Nadège Roche-Labarbe ◽  
Angela Fenoglio ◽  
Alpna Aggarwal ◽  
Mathieu Dehaes ◽  
Stefan A Carp ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Correlation Spectroscopy ◽  
Chronological Age ◽  
Flow Index ◽  
P Value ◽  
Blood Flow Index

Little is known about cerebral blood flow, cerebral blood volume (CBV), oxygenation, and oxygen consumption in the premature newborn brain. We combined quantitative frequency-domain near-infrared spectroscopy measures of cerebral hemoglobin oxygenation (SO2) and CBV with diffusion correlation spectroscopy measures of cerebral blood flow index (BFix) to determine the relationship between these measures, gestational age at birth (GA), and chronological age. We followed 56 neonates of various GA once a week during their hospital stay. We provide absolute values of SO2 and CBV, relative values of BFix, and relative cerebral metabolic rate of oxygen (rCMRO2) as a function of postmenstrual age (PMA) and chronological age for four GA groups. SO2 correlates with chronological age ( r=−0.54, P value 0.001) but not with PMA ( r=−0.07), whereas BFix and rCMRO2 correlate better with PMA ( r=0.37 and 0.43, respectively, P value 0.001). Relative CMRO2 during the first month of life is lower when GA is lower. Blood flow index and rCMRO2 are more accurate biomarkers of the brain development than SO2 in the premature newborns.

scholarly journals Noninvasive Measurement of Regional Cerebral Blood Flow by Near-Infrared Spectroscopy and Indocyanine Green

1998 ◽  
Vol 18 (4) ◽  
pp. 445-456 ◽  
Author(s):  
Wolfgang M. Kuebler ◽  
Axel Sckell ◽  
Oliver Habler ◽  
Martin Kleen ◽  
Gerhard E. H. Kuhnle ◽  
...  
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Indocyanine Green ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Calculated Data ◽  
Practical Method ◽  
Flow Index ◽  
Noninvasive Technique ◽  
Blood Flow Index

Clinicians lack a practical method for measuring CBF rapidly, repeatedly, and noninvasively at the bedside. A new noninvasive technique for estimation of cerebral hemodynamics by use of near-infrared spectroscopy (NIRS) and an intravenously infused tracer dye is proposed. Kinetics of the infrared tracer indocyanine green were monitored on the intact skull in pigs. According to an algorithm derived from fluorescein flowmetry, a relative blood flow index (BFI) was calculated. Data obtained were compared with cerebral and galeal blood flow values assessed by radioactive microspheres under baseline conditions and during hemorrhagic shock and resuscitation. Blood flow index correlated significantly ( rs = 0.814, P < 0.001) with cortical blood flow but not with galeal blood flow ( rs = 0.258). However, limits of agreement between BFI and CBF are rather wide (± 38.2 ± 6.4 mL 100 g−1 min−1) and require further studies. Data presented demonstrate that detection of tracer kinetics in the cerebrovasculature by NIRS may serve as valuable tool for the noninvasive estimation of regional CBF. Indocyanine green dilution curves monitored noninvasively on the intact skull by NIRS reflect dye passage through the cerebral, not extracerebral, circulation.

Near-infrared spectroscopy and indocyanine green derived blood flow index for noninvasive measurement of muscle perfusion during exercise

2010 ◽  
Vol 108 (4) ◽  
pp. 962-967 ◽  
Author(s):  
Helmut Habazettl ◽  
Dimitris Athanasopoulos ◽  
Wolfgang M. Kuebler ◽  
Harrieth Wagner ◽  
Charis Roussos ◽  
...  
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Indocyanine Green ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Interobserver Variability ◽  
Concentration Curve ◽  
Flow Index ◽  
Blood Flow Index ◽  
Muscle Concentration

Near-infrared spectroscopy (NIRS) with the tracer indocyanine green (ICG) may be used for measuring muscle blood flow (MBF) during exercise, if arterial ICG concentration is measured simultaneously. Although pulse dye densitometry allows for noninvasive measurement of arterial dye concentration, this technique is sensitive to motion and may not be applicable during exercise. The aim of this study was to evaluate a noninvasive blood flow index (BFI), which is derived solely from the muscle ICG concentration curve. In 10 male cyclists 5 mg ICG were injected into an antecubital vein at rest and during cycling at 30, 60, 70, 80, 90, and 100% of previously determined maximal work load. Simultaneously blood was withdrawn through a photodensitometer at 20 ml/min from the radial artery to measure arterial ICG concentration. To measure muscle tissue ICG concentrations, two sets of NIRS optodes were positioned on the skin, one over the left seventh intercostal space and the other over the left vastus lateralis muscle. MBF was calculated from the arterial and muscle concentration data according to Fick's principle. BFI was calculated solely from the muscle concentration curve as ICG concentration difference divided by rise time between 10 and 90% of peak. During exercise mean BFI values changed similarly to MBF in both intercostal and quadriceps muscles and showed excellent correlations with MBF: r = 0.98 and 0.96, respectively. Individual data showed some scattering among BFI and MBF values but still reasonable correlations of BFI with MBF: r = 0.73 and 0.72 for intercostal and quadriceps muscles, respectively. Interobserver variability, as analyzed by Bland-Altman plots, was considerably less for BFI than MBF. These data suggest that BFI can be used for measuring changes in muscle perfusion from rest to maximal exercise. Although absolute blood flow cannot be determined, BFI has the advantages of being essentially noninvasive and having low interobserver variability.

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