scholarly journals Cerebral Oximetry Measurements Results Depending on a Preclinical Skull Phantom Model

Author(s):  
Roberts Leibuss ◽  
Arnija Reihmane ◽  
Lāsma Baltace ◽  
Kārlis Baltacis ◽  
Sabīne Štelmahere ◽  
...  

Abstract It is more common to perform non-invasive examination during general anaesthesia to ensure effective perioperative patient care. To achieve these results, researchers and clinicians are seeking out different technologies and developing new equipment. One such apparatus is a cerebral oximeter, which is used during cardiac surgery with cardiopulmonary bypass for neuroprotection management for reducing risk of postoperative neurological injury (cerebral stroke, neurocognitive dysfunction, and cerebral haemorrhage). A cerebral oximeter performs non-invasive transcutaneous measurements using near infrared radiation to assess the oxygenation of tissues. The objective of the study was to determine if the angle and thickness of a patient’s skull affects measurements. Intralipid water solution, gelatine, and ink were used to make six phantoms with skull thickness ranging from 6 to 11 mm. All phantoms were bent froma0to20 degrees angle. The cerebral oximeter SOMETICS INVOS 5100C was used to perform regional oximetry measurements. For skull thickness of 11 mm, the rSO2 was 45.8% (SD 0.96); for skull thickness of 10 mm, the rSO2 was 45.25% (SD 2.22); for skull thickness of 9 mm, the rSO2 was 32% (SD 1.63); for skull thickness of 8 mm, the rSO2 was 17% (SD 1.83); for skull thickness of 7 mm, the rSO2 was 15% (SD 0); for skull thickness of 6 mm, the rSO2 was 15% (SD 0). No significant changes were observed regarding the angle of the skull phantom. The thickness of the bone layer of the skull phantom affected the regional oximetry results, whereas the angle of the skull did not affect it.

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ryosuke Takegawa ◽  
Kei Hayashida ◽  
Rishabh Choudhary ◽  
Daniel M. Rolston ◽  
Lance B. Becker

AbstractImproving neurological outcomes after cardiac arrest (CA) is the most important patient-oriented outcome for CA research. Near-infrared spectroscopy (NIRS) enables a non-invasive, real-time measurement of regional cerebral oxygen saturation. Here, we demonstrate a novel, non-invasive measurement using NIRS, termed modified cerebral oximetry index (mCOx), to distinguish the severity of brain injury after CA. We aimed to test the feasibility of this method to predict neurological outcome after asphyxial CA in rats. Our results suggest that mCOx is feasible shortly after resuscitation and can provide a surrogate measure for the severity of brain injury in a rat asphyxia CA model.


VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 285-293
Author(s):  
Matej Makovec ◽  
Klemen Kerin ◽  
Milan Skitek ◽  
Aleš Jerin ◽  
Tomislav Klokočovnik

Summary. Background: This study attempted to correlate neurological symptoms in awake patients undergoing carotid endarterectomy (CEA) under local anaesthesia (LA) with serum concentration of S100B protein and measurement of cerebral oximetry with near-infrared spectroscopy (NIRS). Patients and methods: A total of 64 consecutive CEAs in 60 patients operated under LA during an 18-month period were prospectively evaluated. A cerebral oximeter was used to measure cerebral oxygen saturation (rSO2) before and after cross-clamping along with serum concentration of the S100B protein. Selective shunting was performed when neurological changes occurred, regardless of NIRS. Neurological deterioration occurred (neurological symptoms group) in 7 (10.9 %) operations. In 57 (89.1 %) operations, the patients were neurologically stable (no neurological symptoms group). Results: The neurological symptoms that occurred after clamping correlated with an increase in the serum level of S100B ( P = .040). The cut-off of 22.5 % of S100B increase was determined to be optimal for identifying patients with neurological symptoms. There was no correlation between rSO2 decline and neurological symptoms ( P = .675). Two (3.1 %) perioperative strokes occurred. Conclusions: We found a correlation between neurological symptoms and serum S100B protein increase. However, because of the long evaluation time of serum S100B, this monitoring technique cannot be performed during CEA.


2021 ◽  
Vol 10 (13) ◽  
pp. 2938
Author(s):  
Małgorzata Barud ◽  
Wojciech Dabrowski ◽  
Dorota Siwicka-Gieroba ◽  
Chiara Robba ◽  
Magdalena Bielacz ◽  
...  

Measurement of cerebral oximetry by near-infrared spectroscopy provides continuous and non-invasive information about the oxygen saturation of haemoglobin in the central nervous system. This is especially important in the case of patients with traumatic brain injuries. Monitoring of cerebral oximetry in these patients could allow for the diagnosis of inadequate cerebral oxygenation caused by disturbances in cerebral blood flow. It could enable identification of episodes of hypoxia and cerebral ischemia. Continuous bedside measurement could facilitate the rapid diagnosis of intracranial bleeding or cerebrovascular autoregulation disorders and accelerate the implementation of treatment. However, it should be remembered that the method of monitoring cerebral oximetry by means of near-infrared spectroscopy also has its numerous limitations, resulting mainly from its physical properties. This paper summarizes the usefulness of monitoring cerebral oximetry by near-infrared spectroscopy in patients with traumatic brain injury, taking into account the advantages and the disadvantages of this technique.


Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Ryan Healy ◽  
Andres Zorrilla-Vaca ◽  
Wendy Ziai ◽  
Romer Geocadin ◽  
Marek A Mirski ◽  
...  

Introduction: The Glasgow Coma Scale (GCS) score is the most commonly used scale for assessment of patients with acute neurological injury in critical care settings. The post-resuscitation admission GCS score is also a predictor for long term outcome in patients with acute traumatic brain injury. Similarly, cerebral autoregulation (CA) monitoring at the bedside has shown to be an accurate technique for predicting clinical outcomes. This study aimed to investigate the correlation between GCS score and continuous CA measured by near-infrared spectroscopy (NIRS). Methods: Twenty-six comatose patients with acute neurological injury admitted to a neurocritical care unit were monitored continuously with NIRS using ICM plus software from one hour up to three days after the coma onset. The cerebral oximetry index (COx) was calculated as the correlation between the slow waves from regional cerebral oxygen saturation (rSO 2 ) and mean arterial blood pressure (MAP). COx, rSO 2 , MAP and GCS data were prospectively extracted each hour. Pearson correlation was used for determining the relation between the NIRS-based measurements (rSO 2 and COx) and GCS every hour of monitoring. Results: A total of 655 observations (hours) were analyzed from 26 patients (65.4% female) with a mean age of 58 years. Eleven patients had ICH, 8 had SAH, 4 had TBI, one had an ischemic stroke, one had a cardiac arrest, and one had status epilepticus. GCS was significantly correlated with COx (r = 0.21, P < 0.001) and MAP (r = 0.15, P < 0.001). Conversely, rSO 2 showed non-significant correlation with GCS (r = 0.06, P = 0.12). Conclusions: This study shows that GCS correlates well with COx, but not with rSO 2 . Our findings support the utility of NIRS-based COx to follow fluctuations in neurological status of critically ill patients that may be particularly useful in sedated and paralyzed patients.


Author(s):  
Полина Темировна Хомякова ◽  
Аза Валерьевна Писарева ◽  
Александр Петрович Николаев

Данная статья посвящена разработке устройства для неинвазивного измерения процентного содержания гемоглобина в крови с целью выявления гипоксии. Наиболее перспективным методом изучения процессов тканевого дыхания в головном мозге и непосредственного интраоперационного мониторинга церебральной гипоксии считается метод церебральной оксиметрии или спектроскопии в ближнем инфракрасном спектре. Показаны преимущества и недостатки данного метода. Целью настоящей работы является создание тканевого оксиметра для неинвазивного измерения процентного содержания гемоглобина в крови с целью идентификации гипоксии головного мозга у человека. Разрабатываемое устройство в дальнейшем планируется использовать для диагностики ишемического инсульта. Прототип этого устройства был основан на диагностической системе Oxiplex TS от ISS, Inc. Изучение прототипа разрабатываемого устройства показывает, что недостатки конструкции влияют на измерительные функции устройства. В ходе работы исследовательской группой была собрана опытная модель, которая нам позволила провести первые измерения для проверки работоспособности разработанного устройства. Результаты эксперимента показали, что входящий сигнал имеет широкий разброс изменчивости параметров, необходимых для измерения микроциркуляции крови, но компонент импульса может быть измерен точно This article deals with the development of a device for noninvasive measurement of the percentage content of hemoglobin in the blood to detect hypoxia. As a promising method of studying the processes of tissue respiration in the brain and direct intraoperative monitoring of cerebral hypoxia is a method of cerebral oximetry or spectroscopy in the near infrared spectrum. The advantages and disadvantages of this method. The aim of this work is the creation of a tissue oximeter for non-invasive measurement of the percentage content of hemoglobin in the blood to identify hypoxia. The device is planned to be used for the diagnosis of ischemic stroke. A prototype of this device was based on the diagnostic system from the ISS Oxiplex TS, Inc. Analysis of the prototype showed that the design flaws affect the measurement functions of the device. In the course of work of the study group collected a model that allowed us to conduct the first measurement to verify that the developed device. The results of the experiment showed that the incoming signal has a wide spread of variability of parameters needed to measure the microcirculation of blood, but the momentum component can be measured accurately


2020 ◽  
Vol 24 (3) ◽  
pp. 543-549
Author(s):  
A.О. Vlasov

Annotation. Near-infrared spectroscopy (NIRS), non-invasive monitoring of tissue oxygenation in many organs, has potentially high diagnostic and prognostic value in critically ill patients. Aim – to analyze modern scientific data on cerebral oximetry by near infrared spectroscopy in neonatal practice. A selective review of literature science data on Internet databases: Pub Med, UpToDate, Medscape EU and Pediatrics was carried out in retrospect. It has been established that understanding neonatal brain oxygenation may be of great clinical importance, since most neonatal pathology is associated with the brain. Vital monitoring provides important information about the infant's health, but does not offer direct information about oxygenation and brain perfusion. Monitoring brain oxygenation with NIRS, at least during the vulnerable transition period during the first 3 days after birth, provides the clinician with additional important information. It can guide clinical management to prevent brain injury and prevent unnecessary treatment, and can provide important information about the infant’s prognosis. Thus, NIRS is a promising non-invasive technology that provides continuous monitoring of neonatal oxygenation parameters. Significant limitations of the method are the difficulties in the clinical interpretation of regional oxygenation indices, the lack of large-scale studies to determine the normative values of regional oxygenation in newborns and to identify reliable prognostic indicators in violation of regional blood circulation. It is reasonable to expect the results of further research.


2007 ◽  
Vol 79 (8) ◽  
Author(s):  
Jacek Wojciechowski ◽  
Magdalena Sidorowicz ◽  
Krzysztof Szyndler ◽  
Łukasz Znaniecki ◽  
Marcin Trenkner ◽  
...  

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