scholarly journals The Use of Near-Infrared Spectroscopy and/or Transcranial Doppler as Non-Invasive Markers of Cerebral Perfusion in Adult Sepsis Patients With Delirium: A Systematic Review

2021 ◽  
pp. 088506662199709
Author(s):  
Michael D. Wood ◽  
J. Gordon Boyd ◽  
Nicole Wood ◽  
James Frank ◽  
Timothy D. Girard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Transcranial Doppler ◽  
Cerebral Perfusion ◽  
Near Infrared ◽  
Cochrane Library ◽  
Delirium Assessment ◽  
Non Invasive ◽  
The Impact

Background: Several studies have previously reported the presence of altered cerebral perfusion during sepsis. However, the role of non-invasive neuromonitoring, and the impact of altered cerebral perfusion, in sepsis patients with delirium remains unclear. Methods: We performed a systematic review of studies that used near-infrared spectroscopy (NIRS) and/or transcranial Doppler (TCD) to assess adults (≥18 years) with sepsis and delirium. From study inception to July 28, 2020, we searched the following databases: Ovid MedLine, Embase, Cochrane Library, and Web of Science. Results: Of 1546 articles identified, 10 met our inclusion criteria. Although NIRS-derived regional cerebral oxygenation was consistently lower, this difference was only statistically significant in one study. TCD-derived cerebral blood flow velocity was inconsistent across studies. Importantly, both impaired cerebral autoregulation during sepsis and increased cerebrovascular resistance were associated with delirium during sepsis. However, the heterogeneity in NIRS and TCD devices, duration of recording (from 10 seconds to 72 hours), and delirium assessment methods (e.g., electronic medical records, confusion assessment method for the intensive care unit), precluded meta-analysis. Conclusion: The available literature demonstrates that cerebral perfusion disturbances may be associated with delirium in sepsis. However, future investigations will require consistent definitions of delirium, delirium assessment training, harmonized NIRS and TCD assessments (e.g., consistent measurement site and length of recording), as well as the quantification of secondary and tertiary variables (i.e., Cox, Mxa, MAPOPT), in order to fully assess the relationship between cerebral perfusion and delirium in patients with sepsis.

scholarly journals Near-infrared spectroscopy in evaluating psychogenic pseudosyncope—a novel diagnostic approach

QJM ◽  
2019 ◽  
Vol 113 (4) ◽  
pp. 239-244
Author(s):  
P Claffey ◽  
L Pérez-Denia ◽  
G Rivasi ◽  
C Finucane ◽  
R A Kenny
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Cerebral Perfusion ◽  
Near Infrared ◽  
Saturation Index ◽  
Diagnostic Algorithm ◽  
Cerebral Hypoperfusion ◽  
P Value ◽  
Non Invasive ◽  
Eyes Closed

Abstract Background Psychogenic pseudosyncope (PPS), a conversion disorder and syncope mimic, accounts for a large proportion of ‘unexplained syncope’. PPS is diagnosed by reproduction of patients’ symptoms during head-up tilt (HUT). Electroencephalogram (EEG), a time consuming and resource intensive technology, is used during HUT to demonstrate absence of cerebral hypoperfusion during transient loss of consciousness (TLOC). Near-infrared spectroscopy (NIRS) is a simple, non-invasive technology for continuous monitoring of cerebral perfusion. We present a series of patients for whom PPS diagnosis was supported by NIRS during HUT. Methods Eight consecutive patients with suspected PPS referred to a syncope unit underwent evaluation. During HUT, continuous beat-to-beat blood pressure (BP), heart rate (HR) and NIRS-derived tissue saturation index (TSI) were measured. BP, HR and TSI at baseline, time of first symptom, presyncope and apparent TLOC were measured. Patients were given feedback and followed for symptom recurrence. Results Eight predominantly female patients (6/8, 75%) aged 31 years (16–54) were studied with (5/8, 63%) having comorbid psychiatric diagnoses, and (5/8, 63%) presenting with frequent episodes of prolonged TLOC with eyes closed (6/8, 75%). All patients experienced reproduction of typical events during HUT. Systolic BP (mmHg) increased from baseline (129.7 (interquartile range [IQR] 124.9–133.4)) at TLOC (153.0 (IQR 146.7–159.0)) (P-value = 0.012). HR (bpm) increased from baseline 78 (IQR 68.6–90.0) to 115.7 (IQR 93.5–127.9) (P-value = 0.012). TSI (%) remained stable throughout, 71.4 (IQR 67.5–72.9) at baseline vs. 71.0 (IQR 68.2–73.0) at TLOC (P-value = 0.484). Conclusions NIRS provides a non-invasive surrogate of cerebral perfusion during HUT. We propose HUT incorporating NIRS monitoring in the diagnostic algorithm for patients with suspected PPS.

scholarly journals Near-Infrared Spectroscopy (NIRS) versus Hyperspectral Imaging (HSI) to Detect Flap Failure in Reconstructive Surgery: A Systematic Review

Life ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 65
Author(s):  
Anouk A. M. A. Lindelauf ◽  
Alexander G. Saelmans ◽  
Sander M. J. van Kuijk ◽  
René R. W. J. van der Hulst ◽  
Rutger M. Schols
Keyword(s):  
Systematic Review ◽  
Infrared Spectroscopy ◽  
Hyperspectral Imaging ◽  
Near Infrared Spectroscopy ◽  
Free Flap ◽  
Near Infrared ◽  
Flap Survival ◽  
Non Invasive ◽  
Vascular Compromise ◽  
Flap Monitoring

Rapid identification of possible vascular compromise in free flap reconstruction to minimize time to reoperation improves achieving free flap salvage. Subjective clinical assessment, often complemented with handheld Doppler, is the golden standard for flap monitoring; but this lacks consistency and may be variable. Non-invasive optical methods such as near-infrared spectroscopy (NIRS) and hyperspectral imaging (HSI) could facilitate objective flap monitoring. A systematic review was conducted to compare NIRS with HSI in detecting vascular compromise in reconstructive flap surgery as compared to standard monitoring. A literature search was performed using PubMed and Embase scientific database in August 2021. Studies were selected by two independent reviewers. Sixteen NIRS and five HSI studies were included. In total, 3662 flap procedures were carried out in 1970 patients using NIRS. Simultaneously; 90 flaps were performed in 90 patients using HSI. HSI and NIRS flap survival were 92.5% (95% CI: 83.3–96.8) and 99.2% (95% CI: 97.8–99.7). Statistically significant differences were observed in flap survival (p = 0.02); flaps returned to OR (p = 0.04); salvage rate (p < 0.01) and partial flap loss rate (p < 0.01). However, no statistically significant difference was observed concerning flaps with vascular crisis (p = 0.39). NIRS and HSI have proven to be reliable; accurate and user-friendly monitoring methods. However, based on the currently available literature, no firm conclusions can be drawn concerning non-invasive monitoring technique superiority

scholarly journals Fetal Hemoglobin and Tissue Oxygenation Measured With Near-Infrared Spectroscopy—A Systematic Qualitative Review

2021 ◽  
Vol 9 ◽  
Author(s):  
Ena Pritišanac ◽  
Berndt Urlesberger ◽  
Bernhard Schwaberger ◽  
Gerhard Pichler
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Tissue Oxygenation ◽  
Fetal Hemoglobin ◽  
Cochrane Library ◽  
Term Neonates ◽  
Qualitative Review ◽  
Peripheral Muscle ◽  
The Impact

Fetal hemoglobin (HbF) is a principal oxygen carrier in the blood of preterm and term neonates. Compared to adult hemoglobin, it has a significantly higher affinity for oxygen and its oxyhemoglobin dissociation curve (ODC) is left-shifted accordingly. Tissue oxygenation measured with near-infrared spectroscopy (NIRS) during neonatal intensive care is directly affected by hemoglobin concentration. We performed a systematic qualitative review regarding the impact of HbF on tissue oxygenation monitoring by NIRS. The PubMed/Medline, EMBASE, Cochrane library and CINAHL databases were searched from inception to May 2021 for studies relating to HbF and NIRS in preterm and term neonates in the first days and weeks after birth. Out of 1,429 eligible records, four observational studies were included. Three studies found no effect of HbF on cerebral tissue oxygenation. One peripheral NIRS study found a positive correlation between HbF and peripheral fractional oxygen extraction (FOE). Currently available limited data suggest that FHbF could affect peripheral muscle FOE, but seems not to affect cerebral oxygenation in preterm neonates. More studies are needed to draw a final conclusion on this matter, especially concerning the oxygenation changes driven by adult RBC transfusions.

Near-Infrared Spectroscopy in Adult Circulatory Shock: A Systematic Review

2020 ◽  
Vol 35 (10) ◽  
pp. 943-962 ◽  
Author(s):  
Elina Varis ◽  
Ville Pettilä ◽  
Erika Wilkman
Keyword(s):  
Systematic Review ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Circulatory Shock ◽  
Quality Data ◽  
Tissue Oxygen Saturation ◽  
Qualitative Synthesis ◽  
Patient Centered ◽  
The Impact

Background: Circulatory shock affects every third patient in intensive care units and is associated with high mortality. Near-infrared spectroscopy (NIRS) could serve as a means for monitoring tissue perfusion in circulatory shock. Purpose: To assess the evidence of NIRS monitoring in circulatory shock, we conducted a systematic review of the literature. Methods: The study protocol was registered in International Prospective Register of Systematic Reviews (PROSPERO). We searched PubMed, Ovid MEDLINE, Scopus, and EBM Reviews databases. The reference lists of included articles, last volumes of key journals, and NIRS monitor manufacturers’ webpages were searched manually. Two reviewers independently selected included studies. The quality of studies was assessed. The qualitative synthesis was guided by 3 questions: First, does NIRS monitoring improve patient-centered outcomes in adult circulatory shock patient? Second, do NIRS-derived parameters predict patient-centered outcomes, such as mortality and organ dysfunction, and third, does NIRS monitoring give additional information to guide treatment decisions? Main Results: Eighteen observational studies with 927 patients were included. Because of considerable clinical heterogeneity of the data, we were not able to perform a meta-analysis. Also, due to lack of randomized controlled trials, the first review question could not be answered. Based on the current review, baseline tissue oxygen saturation (StO2) however seems to predict mortality and identify patients with most severe forms of circulatory shock. Conclusions: Near-infrared spectroscopy-derived StO2 can predict mortality in circulatory shock, but high-quality data on the impact of NIRS monitoring are lacking. Furthermore, the marked heterogeneity of the studies makes combining the results of individual studies difficult. Standardization of methodology and clinical randomized trials are needed before wider clinical use.

scholarly journals Clinical Utility of Functional Near-Infrared Spectroscopy for Assessment and Prediction of Suicidality: A Systematic Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Y. Q. Lee ◽  
Gabrielle W. N. Tay ◽  
Cyrus S. H. Ho
Keyword(s):  
Systematic Review ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Clinical Utility ◽  
Near Infrared ◽  
Cochrane Library ◽  
Functional Near Infrared Spectroscopy ◽  
Cross Sectional ◽  
Cerebral Hemodynamic ◽  
The Brain

Introduction: Suicide is a pressing psychiatric concern worldwide with no established biomarker. While there is some evidence of the clinical utility of functional near-infrared spectroscopy (fNIRS) in assessing and predicting suicidality, no systematic review of such evidence has been conducted to date. Therefore, this review aimed to systematically review and gather evidence from existing studies that used fNIRS signals to assess suicidality and its associated changes in the brain, and those that examined how such signals correlated with suicide symptomatology.Methods: PubMed, EMBASE, and Cochrane Library databases were used in a systematic literature search for English-language articles published between 2000 and December 19, 2020 that focused on the utility of fNIRS for (i) assessing suicidality and its associated changes in the brain, and (ii) correlating with suicide symptomatology. Studies were included if they utilised fNIRS to evaluate variations in fNIRS-measured cerebral hemodynamic responses in patients with different mental disorders (e.g., major depressive disorder, schizophrenia), as well as in healthy controls, of any age group. Quality of evidence was assessed using the Newcastle-Ottawa quality assessment scale.Results: A total of 7 cross-sectional studies were included in this review, all of which had acceptable quality. Across all studies, fNIRS demonstrated reduced cerebral hemodynamic changes in suicidal individuals when compared to non-suicidal individuals. One study also demonstrated the potential of fNIRS signals in correlating with the severity of suicidality.Conclusions: This review provides a comprehensive, updated review of evidence supporting the clinical utility of fNIRS in the assessment and prediction of suicidality. Further studies involving larger sample sizes, standardised methodology, and longitudinal follow-ups are needed.

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