scholarly journals Near Infrared Spectroscopy (NIRS) in the clinical setting – An adjunct to monitoring during diagnosis and treatment

2005 ◽  
Vol 19 (5,6) ◽  
pp. 221-233 ◽  
Author(s):  
R. E. Gagnon ◽  
A. J. Macnab
Keyword(s):  
Blood Flow ◽  
Near Infrared ◽  
Tissue Oxygenation ◽  
Medical Literature ◽  
Redox Status ◽  
Cellular Respiration ◽  
Animal Trials ◽  
Wide Range ◽  
Oxygenation Status ◽  
Monitoring Devices

Since clinical near infrared spectrophotometers (NIRS) first became commercially available in the early 1990's there have been more than two thousand related peer reviewed reports in the medical literature. These encompass a wide range of human and animal trials that have been directed at validating the principles, methods, and algorithms underlying the technology, as well as demonstrating its potential for specific clinical uses such as detecting concealed bleeding, onset of hypoxia, progress of ischemia, and tissue oxygenation status within human brain, muscles, organs, and tumours. In addition to its standard use as a monitor of patterns of change in the concentrations of oxygenated, and de-oxygenated hemoglobin residing in blood, NIRS has also been used to monitor patterns of change in the redox status of the cellular respiration enzyme, cytochrome c oxidase (Cyt a,a3) which utilizes the oxygen diffused from the blood. Accompanied by a tracer bolus of near infrared absorbing dye, NIRS has also been used to measure the proportional blood flow and blood volume transiting organs. NIRS has been used in conjunction with PET, fMRI, BOLD-fMRI, TCD, vascular flowmetry, MRS, NMR, plethysmography, PO2histography, EEG, ECG, EMG, SSEP, MEP, MEG, and standard bedside monitoring devices. Herein we summarize the history, technique, algorithms, methods and advances of clinical NIRS.

scholarly journals Increased tissue oxygenation explains the attenuation of hyperemia upon repetitive pneumatic compression of the lower leg

2017 ◽  
Vol 123 (6) ◽  
pp. 1451-1460 ◽  
Author(s):  
Alessandro Messere ◽  
Gianluca Ceravolo ◽  
Walter Franco ◽  
Daniela Maffiodo ◽  
Carlo Ferraresi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Blood Volume ◽  
Near Infrared ◽  
Tissue Oxygenation ◽  
Femoral Vein ◽  
Lower Leg ◽  
Local Circulation ◽  
Doppler Measurement ◽  
Key Factor ◽  
Interstimulus Intervals

The rapid hyperemia evoked by muscle compression is short lived and was recently shown to undergo a rapid decrease even in spite of continuing mechanical stimulation. The present study aims at investigating the mechanisms underlying this attenuation, which include local metabolic mechanisms, desensitization of mechanosensitive pathways, and reduced efficacy of the muscle pump. In 10 healthy subjects, short sequences of mechanical compressions ( n = 3–6; 150 mmHg) of the lower leg were delivered at different interstimulus intervals (ranging from 20 to 160 s) through a customized pneumatic device. Hemodynamic monitoring included near-infrared spectroscopy, detecting tissue oxygenation and blood volume in calf muscles, and simultaneous echo-Doppler measurement of arterial (superficial femoral artery) and venous (femoral vein) blood flow. The results indicate that 1) a long-lasting (>100 s) increase in local tissue oxygenation follows compression-induced hyperemia, 2) compression-induced hyperemia exhibits different patterns of attenuation depending on the interstimulus interval, 3) the amplitude of the hyperemia is not correlated with the amount of blood volume displaced by the compression, and 4) the extent of attenuation negatively correlates with tissue oxygenation ( r = −0,78, P < 0.05). Increased tissue oxygenation appears to be the key factor for the attenuation of hyperemia upon repetitive compressive stimulation. Tissue oxygenation monitoring is suggested as a useful integration in medical treatments aimed at improving local circulation by repetitive tissue compression. NEW & NOTEWORTHY This study shows that 1) the hyperemia induced by muscle compression produces a long-lasting increase in tissue oxygenation, 2) the hyperemia produced by subsequent muscle compressions exhibits different patterns of attenuation at different interstimulus intervals, and 3) the extent of attenuation of the compression-induced hyperemia is proportional to the level of oxygenation achieved in the tissue. The results support the concept that tissue oxygenation is a key variable in blood flow regulation.

scholarly journals Portable Near-Infrared Technologies and Devices for Noninvasive Assessment of Tissue Hemodynamics

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Lin Hou ◽  
Yinqiu Liu ◽  
Lixia Qian ◽  
Yucong Zheng ◽  
Jinnan Gao ◽  
...  
Keyword(s):  
Blood Flow ◽  
Flow Measurement ◽  
Near Infrared ◽  
Tissue Oxygenation ◽  
Oxygen Metabolism ◽  
Correlation Spectroscopy ◽  
Tissue Blood Flow ◽  
Diffuse Optical Spectroscopy ◽  
Diffuse Correlation Spectroscopy ◽  
Custom Made

Tissue hemodynamics, including the blood flow, oxygenation, and oxygen metabolism, are closely associated with many diseases. As one of the portable optical technologies to explore human physiology and assist in healthcare, near-infrared diffuse optical spectroscopy (NIRS) for tissue oxygenation measurement has been developed for four decades. In recent years, a dynamic NIRS technology, namely, diffuse correlation spectroscopy (DCS), has been emerging as a portable tool for tissue blood flow measurement. In this article, we briefly describe the basic principle and algorithms for static NIRS and dynamic NIRS (i.e., DCS). Then, we elaborate on the NIRS instrumentation, either commercially available or custom-made, as well as their applications to physiological studies and clinic. The extension of NIRS/DCS from spectroscopy to imaging was depicted, followed by introductions of advanced algorithms that were recently proposed. The future prospective of the NIRS/DCS and their feasibilities for routine utilization in hospital is finally discussed.

Tissue perfusion monitoring in the ICU

2016 ◽  
Author(s):  
Eric Kipnis ◽  
Benoit Vallet
Keyword(s):  
Blood Flow ◽  
Tissue Oxygenation ◽  
Venous Pressure ◽  
Blood Gas Analysis ◽  
Tissue Perfusion ◽  
Gas Analysis ◽  
Cellular Respiration ◽  
Tissue Blood Flow ◽  
Central Venous ◽  
Metabolic Markers

Resuscitation endpoints have shifted away from restoring normal values of routinely assessed haemodynamic parameters (central venous pressure, mean arterial pressure, cardiac output) towards optimizing parameters that reflect adequate tissue perfusion. Tissue perfusion-based endpoints have changed outcomes, particularly in sepsis. Tissue perfusion can be explored by monitoring the end result of perfusion, namely tissue oxygenation, metabolic markers, and tissue blood flow. Tissue oxygenation can be directly monitored locally through invasive electrodes or non-invasively using light absorbance (pulse oximetry (SpO2) or tissue (StO2)). Global oxygenation may be monitored in blood, either intermittently through blood gas analysis, or continuously with specialized catheters. Central venous saturation (ScvO2) indirectly assesses tissue oxygenation as the net balance between global O2 delivery and uptake, decreasing when delivery does not meet demand. Lactate, a by-product of anaerobic glycolysis, increases when oxygenation is inadequate, and can be measured either globally in blood, or locally in tissues by microdialysis. Likewise, CO2 (a by-product of cellular respiration) and PCO2 can be measured globally in blood or locally in accessible mucosal tissues (sublingual, gastric) by capnography or tonometry. Increasing PCO2 gradients, either tissue-to-arterial or venous-to-arterial, are due to inadequate perfusion. Metabolically, the oxidoreductive status of mitochondria can be assessed locally through NADH fluorescence, which increases in situations of inadequate oxygenation/perfusion. Finally, local tissue blood flow may be measured by laser-Doppler or visualized through intravital microscopic imaging. These perfusion/oxygenation resuscitation endpoints are increasingly used and studied in critical care.

A method for assessing heterogeneity of blood flow and metabolism in exercising normal human muscle by near-infrared spectroscopy

2015 ◽  
Vol 118 (6) ◽  
pp. 783-793 ◽  
Author(s):  
Ioannis Vogiatzis ◽  
Helmut Habazettl ◽  
Zafeiris Louvaris ◽  
Vasileios Andrianopoulos ◽  
Harrieth Wagner ◽  
...  
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Vastus Lateralis ◽  
Regional Distribution ◽  
Human Muscle ◽  
Relative Dispersion ◽  
Wide Range ◽  
Normal Human

Heterogeneity in the distribution of both blood flow (Q̇) and O2 consumption (V̇o2) has not been assessed by near-infrared spectroscopy in exercising normal human muscle. We used near-infrared spectroscopy to measure the regional distribution of Q̇ and V̇o2 in six trained cyclists at rest and during constant-load exercise (unloaded pedaling, 20%, 50%, and 80% of peak Watts) in both normoxia and hypoxia (inspired O2 fraction = 0.12). Over six optodes over the upper, middle, and lower vastus lateralis, we recorded 1) indocyanine green dye inflow after intravenous injection to measure Q̇; and 2) fractional tissue O2 saturation (StiO2) to estimate local V̇o2-to-Q̇ ratios (V̇o2/Q̇). Varying both exercise intensity and inspired O2 fraction provided a (directly measured) femoral venous O2 saturation range from about 10 to 70%, and a correspondingly wide range in StiO2. Mean Q̇-weighted StiO2 over the six optodes related linearly to femoral venous O2 saturation in each subject. We used this relationship to compute local muscle venous blood O2 saturation from StiO2 recorded at each optode, from which local V̇o2/Q̇ could be calculated by the Fick principle. Multiplying regional V̇o2/Q̇ by Q̇ yielded the corresponding local V̇o2. While six optodes along only in one muscle may not fully capture the extent of heterogeneity, relative dispersion of both Q̇ and V̇o2 was ∼0.4 under all conditions, while that for V̇o2/Q̇ was minimal (only ∼0.1), indicating in fit young subjects 1) a strong capacity to regulate Q̇ according to regional metabolic need; and 2) a likely minimal impact of heterogeneity on muscle O2 availability.

Noninvasive assessment of sympathetic vasoconstriction in human and rodent skeletal muscle using near-infrared spectroscopy and Doppler ultrasound

2004 ◽  
Vol 96 (4) ◽  
pp. 1323-1330 ◽  
Author(s):  
Paul J. Fadel ◽  
David M. Keller ◽  
Hitoshi Watanabe ◽  
Peter B. Raven ◽  
Gail D. Thomas
Keyword(s):  
Skeletal Muscle ◽  
Blood Flow ◽  
Doppler Ultrasound ◽  
Near Infrared ◽  
Tissue Oxygenation ◽  
Nir Spectroscopy ◽  
Sympathetic Nerves ◽  
Sympathetic Activation ◽  
Sympathetic Vasoconstriction ◽  
Highly Correlated

The precise role of the sympathetic nervous system in the regulation of skeletal muscle blood flow during exercise has been challenging to define in humans, partly because of the limited techniques available for measuring blood flow in active muscle. Recent studies using near-infrared (NIR) spectroscopy to measure changes in tissue oxygenation have provided an alternative method to evaluate vasomotor responses in exercising muscle, but this approach has not been fully validated. In this study, we tested the hypothesis that sympathetic activation would evoke parallel changes in tissue oxygenation and blood flow in resting and exercising muscle. We simultaneously measured tissue oxygenation with NIR spectroscopy and blood flow with Doppler ultrasound in skeletal muscle of conscious humans ( n = 13) and anesthetized rats ( n = 9). In resting forearm of humans, reflex activation of sympathetic nerves with the use of lower body negative pressure produced graded decreases in tissue oxygenation and blood flow that were highly correlated ( r = 0.80, P < 0.0001). Similarly, in resting hindlimb of rats, electrical stimulation of sympathetic nerves produced graded decreases in tissue oxygenation and blood flow velocity that were highly correlated ( r = 0.93, P < 0.0001). During rhythmic muscle contraction, the decreases in tissue oxygenation and blood flow evoked by sympathetic activation were significantly attenuated ( P < 0.05 vs. rest) but remained highly correlated in both humans ( r = 0.80, P < 0.006) and rats ( r = 0.92, P < 0.0001). These data indicate that, during steady-state metabolic conditions, changes in tissue oxygenation can be used to reliably assess sympathetic vasoconstriction in both resting and exercising skeletal muscle.

The use of near-infrared spectroscopy in the diagnosis of peripheral artery disease: A systematic review

Vascular ◽  
2021 ◽  
pp. 170853812110251
Author(s):  
Tomas Baltrūnas ◽  
Valerija Mosenko ◽  
Artūras Mackevičius ◽  
Vilius Dambrauskas ◽  
Ingrida Ašakienė ◽  
...  
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Tissue Oxygenation ◽  
Arterial Disease ◽  
Diabetic Patients ◽  
Peripheral Artery ◽  
Artery Disease ◽  
Peripheral Arterial

Background Peripheral arterial disease is a stenosis or occlusion of peripheral arteries that results in compromised blood flow and muscle ischemia. The available diagnostic methods are mostly used to measure and visualize blood flow and are not useful in the evaluation of perfusion, especially in diabetic patients, which is now considered to be a research priority by most of the vascular societies around the world as this is still a relatively poorly studied phenomenon. Objective The aim of this review is to explore the clinical significance of muscle tissue oxygenation monitoring in lower-extremity peripheral artery disease diagnosis using the near-infrared spectroscopy method. Methods A systematic search in PubMed, CINAHL, and Cochrane databases was performed to identify clinical near-infrared spectroscopy (NIRS) studies in English and Russian, published until September 2019, involving muscle tissue oxygenation in peripheral arterial disease (PAD). The manuscripts were reviewed by two researchers independently and scored on the quality of the research using MINORS criteria. Results After screening 443 manuscripts, 23 studies ( n = 1580) were included. NIRS-evaluated recovery time seems to be more accurate than ankle-brachial index in diabetic patients to differentiate between moderate and severe claudication. Consistent findings across all the included studies showed that both the oxygenation and deoxygenation rates as well as the recovery times varied from patient to patient and therefore were not suitable for standardization. Conclusions The clinical relevance of routine use of NIRS to diagnose PAD is unproven; therefore, its use is not currently part of standard-of-care for patients with PAD since the absolute values seem to vary significantly, depending on the outside conditions. More data need to be provided on the possible use of NIRS monitoring intraoperatively where the conditions can be more controlled.

scholarly journals Near infrared spectroscopy: A diagnostic tool to evaluate effects of radiotherapy in the mandible?

2011 ◽  
Vol 26 (1) ◽  
pp. 11-32 ◽  
Author(s):  
Peter Reher ◽  
Bruno Ramos Chrcanovic ◽  
Roger Springett ◽  
Malcolm Harris
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Neck Region ◽  
Great Variability ◽  
Head And Neck Region ◽  
The Right ◽  
Oxygenation Status ◽  
Very High

Purpose. This study tests the hypothesis that near infrared spectroscopy can be used to detect changes in haemoglobin oxygenation status in the mandible, and therefore can be used to monitor the deleterious effects of radiotherapy and the possible reversion of these effects with therapeutic ultrasound. Methods. A probe was used to calculate the concentrations of deoxyhaemoglobin in the mandible bone of 30 volunteers with no known malignancies and 10 patients with malignancies in the head and neck region treated with radiotherapy. Results. Although the variability of the measurements was very high, when comparing the right side to the left side of the mandible, the measurements remained relatively similar. There was a great variability between the data for each patient, there was no correlation with age. Conclusions. The near infrared spectroscopy validation for the measurement of deoxyhaemoglobin concentrations in the mandible showed that the variability of the measurements was very high, therefore it is not appropriate to be used diagnostically for the evaluation of radiotherapy effects on the mandibular blood flow and metabolic status.

Tissue Oxygenation by Near-Infrared Spectroscopy and Muscle Blood Flow During Isometric Contractions of the Forearm

1999 ◽  
Vol 24 (3) ◽  
pp. 216-230 ◽  
Author(s):  
Andrew Hicks ◽  
Stuart Mcgill ◽  
Richard L. Hughson
Keyword(s):  
Blood Flow ◽  
Infrared Spectroscopy ◽  
Doppler Ultrasound ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Tissue Oxygenation ◽  
Muscle Blood Flow ◽  
Venous Blood ◽  
Muscle Oxygenation ◽  
Isometric Contractions

The relationship between tissue oxygenation measured by near-infrared spectroscopy (NIRS) and forearm muscle blood flow (FBF) measured by Doppler ultrasound was tested during isometric contractions at 10 and 30% maximal voluntary contraction (MVC) under conditions of normoxia and hypoxia (14% inspired O2). Six subjects maintained contractions at 10% MVCfor 5 min and at 30% for 2 min in both gas conditions. FBF was elevated during exercise at 10% MVC in hypoxia compared to normoxia, but there was no further increase in flow at 30% MVC. Median power frequency calculations from electromyographic recordings suggested progressive development of fatigue throughout both 10 and 30% MVC contractions. NIRS indicated no change in muscle oxygenation at 10% MVC, but deep venous blood O2 saturation was reduced in normoxia and more so in hypoxia. At 30% MVC, both NIRS and venous O2 saturation were reduced, with no effect of hypoxia on the NIRS signal. While NIRS might provide an indication of muscle oxygenation during isometric exercise, the conflicting findings for NIRS and direct venous blood sampling at 10 vs. 30% MVC suggest caution in the application of this noninvasive technique. Key words: exercise, Doppler ultrasound, venous blood. O2 saturation, hemoglobin

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