scholarly journals Features of cerebral oximetry indicators in different types of combined anesthesia in children with congenital surgical pathology

2021 ◽  
Vol 17 (1) ◽  
pp. 44-49
Author(s):  
A.О. Vlasov
Keyword(s):  
Blood Pressure ◽  
Infrared Spectroscopy ◽  
Regional Anesthesia ◽  
Near Infrared Spectroscopy ◽  
Congenital Malformations ◽  
Near Infrared ◽  
Cerebral Oximetry ◽  
Partial Pressure Of Co2 ◽  
Combined Anesthesia ◽  
The Brain

Background. In the past decade, near-infrared spectroscopy has gained popularity in neonatal wards. Taking into account modern international experience, the presented work assesses the features of cerebral oximetry in children with surgical congenital malformations under various types of combined anesthesia. The purpose of the study was to assess the state of cerebral oxygenation in newborns and infants with congenital malformations in various types of anesthetic support. Materials and methods. A retrospective study included 150 newborns and infants with surgical congenital malformations, depending on the anesthesia (inhalation + regional anesthesia; inhalation + intravenous and total intravenous anesthesia). The parameters of cerebral oximetry were analyzed in comparison with peripheral saturation, blood pressure, partial pressure of CO2, O2 in the blood, and pH. Results. The minimum index of cerebral oximetry was observed in the left brain hemisphere of children in group I — 50.57 ± 16.66 that may be an unfavorable prognostic factor for further recovery and influence on the cognitive functions of the brain. One hour after the operation, the children of the first group, who received combined anesthesia with sevorane and regional anesthesia, showed the worse indicators of cerebral oxi­metry compared to groups II and III (rSO2 of the right hemisphere in the first group — 56.84 ± 12.27, rSO2 of the left hemisphere in the first group — 57.53 ± 13.32, p = 0.0001; 0.0028), while the differences in this indicator between groups II and III were not found (p = 0.4167; 0.4029). Conclusions. Near-infrared spectroscopy has proven to be a simple, feasible and useful method for monitoring the oxygen saturation of the brain. When choosing a combined anesthesia by inhalation and regional anesthesia in child­ren with congenital malformations for surgical treatment, cerebral oxyge­nation should be more carefully monitored with additional control of peripheral saturation, blood pressure, partial pressure of CO2, O2 in the blood and pH.

Assessment of Cerebral Autoregulation Patterns with Near-infrared Spectroscopy during Pharmacological-induced Pressure Changes

2015 ◽  
Vol 123 (2) ◽  
pp. 327-335 ◽  
Author(s):  
Annelies T. Moerman ◽  
Valerie M. Vanbiervliet ◽  
Astrid Van Wesemael ◽  
Stefaan M. Bouchez ◽  
Patrick F. Wouters ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Cerebral Autoregulation ◽  
Near Infrared ◽  
Pressure Effects ◽  
Cerebral Oximetry ◽  
Spearman Correlation ◽  
Elective Cardiac Surgery ◽  
Pressure Changes

Abstract Background: Previous work has demonstrated paradoxical increases in cerebral oxygen saturation (ScO2) as blood pressure decreases and paradoxical decreases in ScO2 as blood pressure increases. It has been suggested that these paradoxical responses indicate a functional cerebral autoregulation mechanism. Accordingly, the authors hypothesized that if this suggestion is correct, paradoxical responses will occur exclusively in patients with intact cerebral autoregulation. Methods: Thirty-four patients undergoing elective cardiac surgery were included. Cerebral autoregulation was assessed with the near-infrared spectroscopy–derived cerebral oximetry index (COx), computed by calculating the Spearman correlation coefficient between mean arterial pressure and ScO2. COx less than 0.30 was previously defined as functional autoregulation. During cardiopulmonary bypass, 20% change in blood pressure was accomplished with the use of nitroprusside for decreasing pressure and phenylephrine for increasing pressure. Effects on COx were assessed. Data were analyzed using two-way ANOVA, Kruskal–Wallis test, and Wilcoxon and Mann–Whitney U test. Results: Sixty-five percent of patients had a baseline COx less than 0.30, indicating functional baseline autoregulation. In 50% of these patients (n = 10), COx became highly negative after vasoactive drug administration (from −0.04 [−0.25 to 0.16] to −0.63 [−0.83 to −0.26] after administration of phenylephrine, and from −0.05 [−0.19 to 0.17] to −0.55 [−0.94 to −0.35] after administration of nitroprusside). A negative COx implies a decrease in ScO2 with increase in pressure and, conversely, an increase in ScO2 with decrease in pressure. Conclusions: In this study, paradoxical changes in ScO2 after pharmacological-induced pressure changes occurred exclusively in patients with intact cerebral autoregulation, corroborating the hypothesis that these paradoxical responses might be attributable to a functional cerebral autoregulation.

scholarly journals Recent advances in cerebral oximetry. Assessment of cerebral autoregulation with near-infrared spectroscopy: myth or reality?

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 1615 ◽  
Author(s):  
Anneliese Moerman ◽  
Stefan De Hert
Keyword(s):  
Blood Pressure ◽  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Cerebral Autoregulation ◽  
Near Infrared ◽  
Cerebral Oximetry ◽  
Cerebral Oxygen ◽  
Pressure Management ◽  
Major Step ◽  
The Individual

In recent years, the feasibility of near-infrared spectroscopy to continuously assess cerebral autoregulation has gained increasing interest. By plotting cerebral oxygen saturation over blood pressure, clinicians can generate an index of autoregulation: the cerebral oximetry index (COx). Successful integration of this monitoring ability in daily critical care may allow clinicians to tailor blood pressure management to the individual patient’s need and might prove to be a major step forward in terms of patient outcome.

scholarly journals Efficacy of near-infrared spectroscopy cerebral oximetry on detection of critical cerebral perfusion during carotid endarterectomy under regional anesthesia

VASA ◽  
2020 ◽  
Vol 49 (5) ◽  
pp. 367-374
Author(s):  
João P. Rocha-Neves ◽  
Juliana Pereira-Macedo ◽  
André L. Moreira ◽  
José P. Oliveira-Pinto ◽  
Graça Afonso ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Carotid Endarterectomy ◽  
Regional Anesthesia ◽  
Near Infrared Spectroscopy ◽  
Operating Characteristic ◽  
Near Infrared ◽  
Cerebral Oximetry ◽  
Cerebral Hypoperfusion ◽  
Cerebral Oxygen

Summary: Background: Patients undergoing carotid endarterectomy (CEA) may suffer from cerebral hypoperfusion during the carotid cross-clamping. Near-infrared spectroscopy cerebral oximetry (NIRS) is a non-invasive method of regional cerebral oxygen saturation measurement reflecting changes in cerebral blood flow during CEA. The main goal of the study was to evaluate the accuracy of the NIRS in detecting cerebral hypoperfusion during CEA under regional anesthesia (RA) and compare it with awake neurological testing. Patients and methods: A prospective observational study of 28 patients that underwent CEA in RA and manifested neurologic deficits, and 28 consecutive controls from a tertiary and referral center, was performed. All patients were monitored with NIRS cerebral oximetry and awake testing as the control technique. Subsequently, operating characteristic curve and Cohen’s kappa coefficient were determined to evaluate the reliability of the monitoring test. Results: NIRS presented a sensitivity of 27.3% and a specificity of 89.3% in comparison to awake testing. Receiver operating characteristic (ROC) curve analysis demonstrated that a decrease of at least 20% in cerebral oxygen saturation is the best threshold to infer cerebral hypoperfusion. However, the respective area under the curve (AUROC) was 0.606 (95% CI: 0.456–0.756, P = 0.178) with a calculated Cohen’s kappa of 0.179, P = 0.093. Regarding 30-days outcomes, only awake testing has shown significant associations with stroke and postoperative complications ( P = 0.043 and P = 0.05), which were higher in patients with post-clamping neurologic deficits. Conclusions: NIRS demonstrated a reduced discriminative capacity for critical cerebral hypoperfusion, and does not seem to add substantial clinical benefits to the awake test.

scholarly journals Mismatch between Tissue Partial Oxygen Pressure and Near-Infrared Spectroscopy Neuromonitoring of Tissue Respiration in Acute Brain Trauma: The Rationale for Implementing a Multimodal Monitoring Strategy

2021 ◽  
Vol 22 (3) ◽  
pp. 1122
Author(s):  
Mario Forcione ◽  
Mario Ganau ◽  
Lara Prisco ◽  
Antonio Maria Chiarelli ◽  
Andrea Bellelli ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Oxygen Pressure ◽  
Near Infrared ◽  
Optical Signal ◽  
Brain Trauma ◽  
Partial Oxygen Pressure ◽  
Tissue Respiration ◽  
The Brain ◽  
Partial Oxygen

The brain tissue partial oxygen pressure (PbtO2) and near-infrared spectroscopy (NIRS) neuromonitoring are frequently compared in the management of acute moderate and severe traumatic brain injury patients; however, the relationship between their respective output parameters flows from the complex pathogenesis of tissue respiration after brain trauma. NIRS neuromonitoring overcomes certain limitations related to the heterogeneity of the pathology across the brain that cannot be adequately addressed by local-sample invasive neuromonitoring (e.g., PbtO2 neuromonitoring, microdialysis), and it allows clinicians to assess parameters that cannot otherwise be scanned. The anatomical co-registration of an NIRS signal with axial imaging (e.g., computerized tomography scan) enhances the optical signal, which can be changed by the anatomy of the lesions and the significance of the radiological assessment. These arguments led us to conclude that rather than aiming to substitute PbtO2 with tissue saturation, multiple types of NIRS should be included via multimodal systemic- and neuro-monitoring, whose values then are incorporated into biosignatures linked to patient status and prognosis. Discussion on the abnormalities in tissue respiration due to brain trauma and how they affect the PbtO2 and NIRS neuromonitoring is given.

scholarly journals Functional Near Infrared Spectroscopy (fNIRS) based Odor Detection and Classification using Functional Data Analysis

2021 ◽  
Author(s):  
Faezeh Moradi ◽  
Shima T. Moein ◽  
Issa Zakeri ◽  
Kambiz Pourrezaei
Keyword(s):  
Infrared Spectroscopy ◽  
Data Analysis ◽  
Near Infrared Spectroscopy ◽  
Functional Data Analysis ◽  
Functional Data ◽  
Near Infrared ◽  
Stimulus Condition ◽  
Functional Near Infrared Spectroscopy ◽  
Odor Detection ◽  
The Brain

AbstractAn objective approach for odor detection is to analyze the brain activity using imaging techniques during the odor stimulation. In this study, Functional Near Infrared Spectroscopy (fNIRS) is used to record hemodynamic response from the frontal region of the brain by using a 4-channel fNIRS system. The fNIRs data is collected during the odor detection task in which the subjects were asked to press a button when they detect the given odor. Functional Data Analysis (FDA) was applied on fNIRs data to convert discrete measured samples of data to continuous smooth curves. The FDA method enables us to use the bases coefficients of fNIRS smoothed curves for features that represent the shape of the raw fNIRS signal. With the learning algorithm that we proposed, these features were used to train the support vector machine classifier. We evaluated the odor detection problem, in two binary classification cases: odorant vs. non-odorant and odorant vs. fingertapping. The model achieved a classification accuracy of 94.12% and 97.06% over the stimulus condition in the two cases, respectively. Moreover to find the actual predictors we used the extracted defined features (slope, standard deviation, and delta) to train our classifier. We achieved an average accuracy of 91.18 % on classifying odorant vs. non-odorant and an accuracy of 94.12% for odorant vs. fingertapping on the stimulus condition. The results determined that fNIRs signals of odorant and non-odorant are distinguishable without being affected by the motor activity during the experiment.These findings suggest that fNIRs measurement on the forehead could be potentially used for objective and comparably inexpensive assessment of odor detection in cases that the subjective report is unreliable.

scholarly journals Brain–Computer Interfacing Using Functional Near-Infrared Spectroscopy (fNIRS)

Biosensors ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 389
Author(s):  
Kogulan Paulmurugan ◽  
Vimalan Vijayaragavan ◽  
Sayantan Ghosh ◽  
Parasuraman Padmanabhan ◽  
Balázs Gulyás
Keyword(s):  
Infrared Spectroscopy ◽  
Near Infrared Spectroscopy ◽  
Brain Function ◽  
Near Infrared ◽  
Functional Near Infrared Spectroscopy ◽  
Non Invasive ◽  
Neuron Function ◽  
Brain Computer Interfacing ◽  
The Brain ◽  
Computer Interfacing

Functional Near-Infrared Spectroscopy (fNIRS) is a wearable optical spectroscopy system originally developed for continuous and non-invasive monitoring of brain function by measuring blood oxygen concentration. Recent advancements in brain–computer interfacing allow us to control the neuron function of the brain by combining it with fNIRS to regulate cognitive function. In this review manuscript, we provide information regarding current advancement in fNIRS and how it provides advantages in developing brain–computer interfacing to enable neuron function. We also briefly discuss about how we can use this technology for further applications.

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