Noninvasive Cellular Oxygenation Measurement During Graded Hypoxia Using Visible–Near-Infrared Spectroscopy

2020 ◽  
Vol 74 (10) ◽  
pp. 1263-1273
Author(s):  
Lorilee S.L. Arakaki ◽  
Wayne A. Ciesielski ◽  
D. Michael McMullan ◽  
Kenneth A. Schenkman
Keyword(s):  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Serum Lactate ◽  
Arterial Blood ◽  
Direct Knowledge ◽  
Steady State Serum ◽  
Cellular Hypoxia ◽  
Low Levels ◽  
Changes Over Time ◽  
Inspired Oxygen

In critically ill patients, direct knowledge of intracellular pO2 would allow for identification of cellular hypoxia, which when prolonged leads to organ failure. We have developed a visible–near-infrared optical system that noninvasively measures myoglobin saturation, which is directly related to intracellular pO2, from the surface of the skin. We used an animal model of graded hypoxia from low levels of inspired oxygen ( n = 5) and verified that low intracellular pO2 is correlated with high steady-state serum lactate values. In addition, the pO2 gradient between arterial blood and inside muscle cells was 83 mm Hg at 21% O2, but fell to 24 mm Hg at 8% O2. Continuous myoglobin saturation measurement in skeletal muscle displayed the same trends as cerebral oxygenation with no lag in changes over time, demonstrating its relevance as a measure of systemic oxygenation.

Near-infrared spectroscopy in newborns and infants under general anesthesia

2012 ◽  
Vol 19 (3) ◽  
pp. 232-236
Author(s):  
Ilona Šuškevičienė ◽  
Danguolė ČeslavaRugytė ◽  
Tomas Bukauskas ◽  
Alina Vilkė ◽  
Diana Bilskienė ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Infrared Spectroscopy ◽  
General Anesthesia ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Muscle Relaxants ◽  
Cardiovascular Disorders ◽  
Arterial Blood ◽  
Term Newborns

The aim of this study was to find out absolute values of cerebral oxygenation during uncomplicated anesthesia in otherwise healthy newborns and infants undergoing general surgery and to correlate them with demographic and clinical variables. We examined 10 term newborns and infants ASA class I or II without any documented neurological and cardiovascular disorders. All patients underwent general anesthesia with sevoflurane, fentanyl and muscle relaxants. After induction of anesthesia, near-infrared spectroscopy (NIRS) was started and used throughout the surgery. Overall mean (standard deviation (sd)) rSO2 value was 84 ± 8% and weakly correlated with weight (r = 0.5), postnatal age (r = 0.2), SpO2 (r = 0.3) and arterial blood pressure (r = 0.2), p 

Physiologically based cord clamping stabilises cardiac output and reduces cerebrovascular injury in asphyxiated near-term lambs

2017 ◽  
Vol 103 (6) ◽  
pp. F530-F538 ◽  
Author(s):  
Graeme R Polglase ◽  
Douglas A Blank ◽  
Samantha K Barton ◽  
Suzanne L Miller ◽  
Vanesa Stojanovska ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Output ◽  
Grey Matter ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Cerebrovascular Injury ◽  
Arterial Blood ◽  
Cord Clamping ◽  
Physiologically Based ◽  
Near Term

BackgroundPhysiologically based cord clamping (PBCC) has advantages over immediate cord clamping (ICC) during preterm delivery, but its efficacy in asphyxiated infants is not known. We investigated the physiology of PBCC following perinatal asphyxia in near-term lambs.MethodsNear-term sheep fetuses (139±2 (SD) days’ gestation) were instrumented to measure umbilical, carotid, pulmonary and femoral arterial flows and pressures. Systemic and cerebral oxygenation was recorded using pulse oximetry and near-infrared spectroscopy, respectively. Fetal asphyxia was induced until mean blood pressure reached ~20 mm Hg, where lambs underwent ICC and initiation of ventilation (n=7), or ventilation for 15 min prior to umbilical cord clamping (PBCC; n=8). Cardiovascular parameters were measured and white and grey matter microvascular integrity assessed using qRT-PCR and immunohistochemistry.ResultsPBCC restored oxygenation and cardiac output at the same rate and in a similar fashion to lambs resuscitated following ICC. However, ICC lambs had a rapid and marked overshoot in mean systemic arterial blood pressure from 1 to 10 min after ventilation onset, which was largely absent in PBCC lambs. ICC lambs had increased cerebrovascular injury, as indicated by reduced expression of blood–brain barrier proteins and increased cerebrovascular protein leakage in the subcortical white matter (by 86%) and grey matter (by 47%).ConclusionPBCC restored cardiac output and oxygenation in an identical time frame as ICC, but greatly mitigated the postasphyxia rebound hypertension measured in ICC lambs. This likely protected the asphyxiated brain from cerebrovascular injury. PBCC may be a more suitable option for the resuscitation of the asphyxiated newborn compared with the current standard of ICC.

Comparison of two commercially available near-infrared spectroscopy instruments for cerebral oximetry

2000 ◽  
Vol 93 (2) ◽  
pp. 351-354 ◽  
Author(s):  
Hun Cho ◽  
Edwin M. Nemoto ◽  
Mark Sanders ◽  
Karl Fernandez ◽  
Howard Yonas
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Random Order ◽  
The United States ◽  
Cerebral Oximetry ◽  
Content Type ◽  
Arterial Blood ◽  
Fine Print

✓ Two near-infrared spectroscopy (NIRS) devices were compared with regard to their responses to changes in cerebral hemoglobin oxygenation induced by hypoxia and hypercapnia in five healthy volunteers.Sensors belonging to each NIRS device were placed on opposite sides of the volunteer's forehead. The INVOS3100A device, approved by the United States Food and Drug Administration, records the percentage of oxyhemoglobin (HbO2) saturation and the investigational NIRO500 device records absolute changes in HbO2, deoxyhemoglobin, and total hemoglobin in micromolar concentrations referenced to an arbitrary baseline. The volunteers breathed separate mixtures of 7% CO2 in O2 and 10% O2 for 5 minutes in random order. Arterial blood pressure, end-tidal CO2 (ETCO2), arterial O2 saturation, and electrocardiographic data were continuously monitored.Hypercapnia increased (p < 0.01) ETCO2 from 42 ± 2 to 56 ± 3 mm Hg (mean ± standard deviation), resulting in a 7.3 ± 0.2% increase (p < 0.005) in cerebral HbO2 saturation detected by the INVOS3100A device and an 11.6 ± 3 µM increase (p < 0.0008) in HbO2 detected by the NIRO500. Hypoxia decreased (p < 0.01) arterial HbO2 saturation from 98 ± 1 to 87 ± 3%, causing a 5.1 ± 1.2% decrease (p < 0.01) in the percentage of HbO2 saturation detected by the INVOS3100A device and a 9.7 ± 6.3 µM decrease in HbO2 detected by the NIRO500.The responses of the NIRO500 and the INVOS3100A instruments to changes in cerebral oxygenation resulting from hypercapnia and hypoxia were generally similar; however, responses tended to be greater when recorded by the NIRO500 device, perhaps because, unlike the INVOS3100A device, the NIRO500 does not correct for skin and bone contamination.

Human cardiorespiratory and cerebrovascular function during severe passive hyperthermia: effects of mild hypohydration

2008 ◽  
Vol 105 (2) ◽  
pp. 433-445 ◽  
Author(s):  
Jui-Lin Fan ◽  
James D. Cotter ◽  
Rebekah A. I. Lucas ◽  
Kate Thomas ◽  
Luke Wilson ◽  
...  
Keyword(s):  
Blood Flow ◽  
Regional Differences ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Blood Flows ◽  
Time Control ◽  
Arterial Blood ◽  
Cerebrovascular Function ◽  
End Tidal ◽  
Passive Hyperthermia

The influence of severe passive heat stress and hypohydration (Hypo) on cardiorespiratory and cerebrovascular function is not known. We hypothesized that 1) heating-induced hypocapnia and peripheral redistribution of cardiac output (Q̇) would compromise blood flow velocity in the middle cerebral artery (MCAv) and cerebral oxygenation; 2) Hypo would exacerbate the hyperthermic-induced hypocapnia, further decreasing MCAv; and 3) heating would reduce MCAv-CO2 reactivity, thereby altering ventilation. Ten men, resting supine in a water-perfused suit, underwent progressive hyperthermia [0.5°C increments in core (esophageal) temperature (TC) to +2°C] while euhydrated (Euh) or Hypo by 1.5% body mass (attained previous evening). Time-control (i.e., non-heat stressed) data were obtained on six of these subjects. Cerebral oxygenation (near-infrared spectroscopy), MCAv, end-tidal carbon dioxide (PetCO2) and arterial blood pressure, Q̇ (flow model), and brachial and carotid blood flows (CCA) were measured continuously each 0.5°C change in TC. At each level, hypercapnia was achieved through 3-min administrations of 5% CO2, and hypocapnia was achieved with controlled hyperventilation. At baseline in Hypo, heart rate, MCAv and CCA were elevated ( P < 0.05 vs. Euh). MCAv-CO2 reactivity was unchanged in both groups at all TC levels. Independent of hydration, hyperthermic-induced hyperventilation caused a severe drop in PetCO2 (−8 ± 1 mmHg/°C), which was related to lower MCAv (−15 ± 3%/°C; R2 = 0.98; P < 0.001). Elevations in Q̇ were related to increases in brachial blood flow ( R2 = 0.65; P < 0.01) and reductions in MCAv ( R2 = 0.70; P < 0.01), reflecting peripheral distribution of Q̇. Cerebral oxygenation was maintained, presumably via enhanced O2-extraction or regional differences in cerebral perfusion.

scholarly journals Variability of L Dwarfs in the Near Infrared

2003 ◽  
Vol 211 ◽  
pp. 455-456 ◽  
Author(s):  
José A. Caballero ◽  
Víctor J. S. Béjar ◽  
Rafael Rebolo
Keyword(s):  
Time Scales ◽  
Near Infrared ◽  
Brown Dwarfs ◽  
L Dwarfs ◽  
Atmospheric Changes ◽  
Changes Over Time ◽  
Over Time

We have obtained series of images in the near infrared J and Ks bands for seven L-type dwarfs with a duration of 3 to 6 hours. We present results on: 1) the amplitude of variability associated with atmospheric changes over time scales from minutes to several hours; 2) the search for cool companions in wide orbits; 3) the search for transits of brown dwarfs and planetary companions in very close orbits.

scholarly journals Causes, Effects and Methods of Monitoring Gas Exchange Disturbances during Equine General Anaesthesia

Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 2049
Author(s):  
Elżbieta Stefanik ◽  
Olga Drewnowska ◽  
Barbara Lisowska ◽  
Bernard Turek
Keyword(s):  
Gas Exchange ◽  
General Anaesthesia ◽  
Near Infrared ◽  
Respiratory Acidosis ◽  
Monitoring Methods ◽  
Arterial Blood Gas ◽  
Complementary Method ◽  
Arterial Blood ◽  
Operative Complications ◽  
Post Operative Complications

Horses, due to their unique anatomy and physiology, are particularly prone to intraoperative cardiopulmonary disorders. In dorsally recumbent horses, chest wall movement is restricted and the lungs are compressed by the abdominal organs, leading to the collapse of the alveoli. This results in hypoventilation, leading to hypercapnia and respiratory acidosis as well as impaired tissue oxygen supply (hypoxia). The most common mechanisms disturbing gas exchange are hypoventilation, atelectasis, ventilation–perfusion (V/Q) mismatch and shunt. Gas exchange disturbances are considered to be an important factor contributing to the high anaesthetic mortality rate and numerous post-anaesthetic side effects. Current monitoring methods, such as a pulse oximetry, capnography, arterial blood gas measurements and spirometry, may not be sufficient by themselves, and only in combination with each other can they provide extensive information about the condition of the patient. A new, promising, complementary method is near-infrared spectroscopy (NIRS). The purpose of this article is to review the negative effect of general anaesthesia on the gas exchange in horses and describe the post-operative complications resulting from it. Understanding the changes that occur during general anaesthesia and the factors that affect them, as well as improving gas monitoring techniques, can improve the post-aesthetic survival rate and minimize post-operative complications.

Continuous Measurement of Cerebral Oxygenation by Near Infrared Spectroscopy During Induction of Anesthesia

1999 ◽  
Vol 88 (3) ◽  
pp. 554-558 ◽  
Author(s):  
A. Timothy Lovell ◽  
Huw Owen-Reece ◽  
Clare E. Elwell ◽  
Martin Smith ◽  
John C. Goldstone
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Continuous Measurement ◽  
Cerebral Oxygenation

scholarly journals Early effects of ventilatory rescue therapies on systemic and cerebral oxygenation in mechanically ventilated COVID-19 patients with acute respiratory distress syndrome: a prospective observational study

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Chiara Robba ◽  
◽  
Lorenzo Ball ◽  
Denise Battaglini ◽  
Danilo Cardim ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Acute Respiratory Distress Syndrome ◽  
Observational Study ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Prospective Observational Study ◽  
Distress Syndrome ◽  
Cerebral Oxygenation ◽  
Arterial Blood ◽  
Early Effects

Abstract Background In COVID-19 patients with acute respiratory distress syndrome (ARDS), the effectiveness of ventilatory rescue strategies remains uncertain, with controversial efficacy on systemic oxygenation and no data available regarding cerebral oxygenation and hemodynamics. Methods This is a prospective observational study conducted at San Martino Policlinico Hospital, Genoa, Italy. We included adult COVID-19 patients who underwent at least one of the following rescue therapies: recruitment maneuvers (RMs), prone positioning (PP), inhaled nitric oxide (iNO), and extracorporeal carbon dioxide (CO2) removal (ECCO2R). Arterial blood gas values (oxygen saturation [SpO2], partial pressure of oxygen [PaO2] and of carbon dioxide [PaCO2]) and cerebral oxygenation (rSO2) were analyzed before (T0) and after (T1) the use of any of the aforementioned rescue therapies. The primary aim was to assess the early effects of different ventilatory rescue therapies on systemic and cerebral oxygenation. The secondary aim was to evaluate the correlation between systemic and cerebral oxygenation in COVID-19 patients. Results Forty-five rescue therapies were performed in 22 patients. The median [interquartile range] age of the population was 62 [57–69] years, and 18/22 [82%] were male. After RMs, no significant changes were observed in systemic PaO2 and PaCO2 values, but cerebral oxygenation decreased significantly (52 [51–54]% vs. 49 [47–50]%, p < 0.001). After PP, a significant increase was observed in PaO2 (from 62 [56–71] to 82 [76–87] mmHg, p = 0.005) and rSO2 (from 53 [52–54]% to 60 [59–64]%, p = 0.005). The use of iNO increased PaO2 (from 65 [67–73] to 72 [67–73] mmHg, p = 0.015) and rSO2 (from 53 [51–56]% to 57 [55–59]%, p = 0.007). The use of ECCO2R decreased PaO2 (from 75 [75–79] to 64 [60–70] mmHg, p = 0.009), with reduction of rSO2 values (59 [56–65]% vs. 56 [53–62]%, p = 0.002). In the whole population, a significant relationship was found between SpO2 and rSO2 (R = 0.62, p < 0.001) and between PaO2 and rSO2 (R0 0.54, p < 0.001). Conclusions Rescue therapies exert specific pathophysiological mechanisms, resulting in different effects on systemic and cerebral oxygenation in critically ill COVID-19 patients with ARDS. Cerebral and systemic oxygenation are correlated. The choice of rescue strategy to be adopted should take into account both lung and brain needs. Registration The study protocol was approved by the ethics review board (Comitato Etico Regione Liguria, protocol n. CER Liguria: 23/2020).

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