Use of Tissue Oxygenation Index and Fractional Tissue Oxygen Extraction as Non-Invasive Parameters for Cerebral Oxygenation

Neonatology ◽  
2007 ◽  
Vol 92 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Gunnar Naulaers ◽  
Bart Meyns ◽  
Marc Miserez ◽  
Veerle Leunens ◽  
Sabine Van Huffel ◽  
...  
Keyword(s):  
Tissue Oxygenation ◽  
Cerebral Oxygenation ◽  
Oxygenation Index ◽  
Oxygen Extraction ◽  
Tissue Oxygen ◽  
Non Invasive ◽  
Tissue Oxygenation Index

Cerebral Arterial and Venous Contributions to Tissue Oxygenation Index Measured Using Spatially Resolved Spectroscopy in Newborn Lambs

2010 ◽  
Vol 113 (6) ◽  
pp. 1385-1391 ◽  
Author(s):  
Flora Y. Wong ◽  
Theodora Alexiou ◽  
Thilini Samarasinghe ◽  
Vojta Brodecky ◽  
Adrian M. Walker
Keyword(s):  
Oxygen Saturation ◽  
Tissue Oxygenation ◽  
Volume Fraction ◽  
Cerebral Oxygenation ◽  
Oxygenation Index ◽  
Arterial Oxygen ◽  
Spatially Resolved ◽  
Tissue Oxygenation Index ◽  
Venous Volume ◽  
Spatially Resolved Spectroscopy

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.

Use of the Liver Tissue Oxygenation Index as a Noninvasive Parameter of Intestinal Ischemia in Rabbits

2007 ◽  
Vol 31 (12) ◽  
pp. 2359-2362 ◽  
Author(s):  
J. Vanderhaegen ◽  
L. Dehing ◽  
G. Naulaers ◽  
H. Devlieger ◽  
Y. Al-Olayet ◽  
...  
Keyword(s):  
Liver Tissue ◽  
Intestinal Ischemia ◽  
Tissue Oxygenation ◽  
Oxygenation Index ◽  
Tissue Oxygenation Index

Can tissue oxygenation index (TOI) and cotside neurophysiological variables predict outcome in depressed/asphyxiated newborn infants?

2007 ◽  
Vol 83 (8) ◽  
pp. 483-489 ◽  
Author(s):  
Patrizia Zaramella ◽  
Elisabetta Saraceni ◽  
Federica Freato ◽  
Elena Falcon ◽  
Agnese Suppiej ◽  
...  
Keyword(s):  
Tissue Oxygenation ◽  
Newborn Infants ◽  
Oxygenation Index ◽  
Tissue Oxygenation Index

Assessment of a noninvasive cerebral oxygenation monitor in patients with severe traumatic brain injury

2014 ◽  
Vol 120 (4) ◽  
pp. 901-907 ◽  
Author(s):  
Guy Rosenthal ◽  
Alex Furmanov ◽  
Eyal Itshayek ◽  
Yigal Shoshan ◽  
Vineeta Singh
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Tissue Oxygenation ◽  
Cerebral Oxygenation ◽  
Jugular Bulb ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Brain Tissue Oxygen ◽  
Severe Tbi ◽  
Cerebral Tissue Oxygenation

Object Development of a noninvasive monitor to assess cerebral oxygenation has long been a goal in neurocritical care. The authors evaluated the feasibility and utility of a noninvasive cerebral oxygenation monitor, the CerOx 3110, which uses near-infrared spectroscopy and ultrasound to measure regional cerebral tissue oxygenation in patients with severe traumatic brain injury (TBI), and compared measurements obtained using this device to those obtained using invasive cerebral monitoring. Methods Patients with severe TBI admitted to the intensive care unit at Hadassah-Hebrew University Hospital requiring intracranial pressure (ICP) monitoring and advanced neuromonitoring were included in this study. The authors assessed 18 patients with severe TBI using the CerOx monitor and invasive advanced cerebral monitors. Results The mean age of the patients was 45.3 ± 23.7 years and the median Glasgow Coma Scale score on admission was 5 (interquartile range 3–7). Eight patients underwent unilateral decompressive hemicraniectomy and 1 patient underwent craniotomy. Sixteen patients underwent insertion of a jugular bulb venous catheter, and 18 patients underwent insertion of a Licox brain tissue oxygen monitor. The authors found a strong correlation (r = 0.60, p < 0.001) between the jugular bulb venous saturation from the venous blood gas and the CerOx measure of regional cerebral tissue saturation on the side ipsilateral to the catheter. A multivariate analysis revealed that among the physiological parameters of mean arterial blood pressure, ICP, brain tissue oxygen tension, and CerOx measurements on the ipsilateral and contralateral sides, only ipsilateral CerOx measurements were significantly correlated to jugular bulb venous saturation (p < 0.001). Conclusions Measuring regional cerebral tissue oxygenation with the CerOx monitor in a noninvasive manner is feasible in patients with severe TBI in the neurointensive care unit. The correlation between the CerOx measurements and the jugular bulb venous measurements of oxygen saturation indicate that the CerOx may be able to provide an estimation of cerebral oxygenation status in a noninvasive manner.

Abstract 153: Non-invasive Measurement of Cerebral Tissue Oxygen Extraction Fraction is Correlated with Microdialysis Brain Injury Biomarkers During Extracorporeal Cardiopulmonary Resuscitation

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Tiffany S Ko ◽  
Julia Slovis ◽  
Lindsay Volk ◽  
Constantine D Mavroudis ◽  
Ryan W Morgan ◽  
...  
Keyword(s):  
Brain Injury ◽  
Oxygen Extraction Fraction ◽  
Oxygen Extraction ◽  
Neurological Injury ◽  
Tissue Oxygen ◽  
Cerebral Tissue ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Glucose Content ◽  
Non Invasive ◽  
Extraction Fraction

Introduction: Extracorporeal membrane oxygenation (ECMO) assisted CPR (ECPR) can improve outcomes after prolonged or unsuccessful resuscitative efforts, but neurological injury remains common in survivors. The lack of routine neuromonitoring during ECPR and ECMO prohibits brain-targeted management to help improve neurological outcomes. In this study, we examine the association of non-invasive, frequency-domain diffuse optical spectroscopy (FD-DOS) measurements of cerebral tissue oxygen extraction fraction (OEF), an indicator of metabolic stress, with invasively collected brain injury biomarkers to explore the utility of this monitoring modality during ECPR. Hypothesis: FD-DOS measurement of cerebral OEF is positively correlated with biomarkers of brain injury (lactate-pyruvate ratio, LPR; glycerol). Methods: Cerebral OEF was continuously monitored by FD-DOS in nine pediatric swine (8-11 kg) who underwent 30-60 minutes of manual CPR, were cannulated for ECMO, and remained on ECMO for 22-24 hours. Cerebral pyruvate, lactate, glycerol and glucose content were measured from cerebral microdialysate samples collected hourly. The correlation between OEF and microdialysis parameters were assessed using a linear mixed-effects model incorporating subject-specific random slope and intercept effects. Significance was determined at p<0.05. Results: Microdialysis parameters from 192 samples were compared against non-invasive OEF values. OEF was significantly correlated with LPR (p=0.001), and relative change in glycerol (p=0.005) and glucose (p=0.020) concentrations from baseline. Conclusions: Non-invasive FD-DOS neuromonitoring of OEF demonstrated significant correlations with invasive brain injury biomarkers; increasing OEF was associated with elevated LPR and glycerol, and diminished glucose. FD-DOS detection of critical neurometabolic stress at the bedside may facilitate brain-targeted ECMO management after cardiac arrest.

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

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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