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

✓ 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.

2003 ◽  
Vol 99 (2) ◽  
pp. 304-310 ◽  
Author(s):  
Yoshihiro Murata ◽  
Yoichi Katayama ◽  
Kaoru Sakatani ◽  
Chikashi Fukaya ◽  
Tsuneo Kano

Object. It has been reported that extracranial—intracranial (EC—IC) arterial bypass surgery can be useful in preventing stroke in patients with hemodynamic compromise. Little is yet known, however, regarding the extent to which the bypass contributes to maintaining adequate cerebral blood oxygenation (CBO) and its temporal changes following surgery. The authors evaluated bypass function repeatedly by using near-infrared spectroscopy (NIRS) after surgery. Methods. The authors investigated 30 patients who had undergone EC—IC bypass surgery. Single-photon emission computerized tomography revealed a decrease in regional cerebral blood flow (rCBF) and a lowered rCBF response to acetazolamide. Changes in CBO were evaluated in the sensorimotor cortex during compression of the anastomosed superficial temporal artery (STA). When decreases in oxyhemoglobin (HbO2) and total hemoglobin (Hb) concentrations were observed, the bypass was considered to have maintained CBO in the sensorimotor cortex given that decreases in HbO2 and total Hb indicate cerebral ischemic changes. The bypass maintained CBO immediately after surgery in 36.7% of patients (Group I, 11 patients) and at some time after surgery, mostly within 1 year, in 43.3% of patients (Group II, 13 patients); however, it did not maintain it throughout the follow-up period in 20% of patients (Group III, six patients). Note that the preoperative rCBF in patients in Groups I and II was lower than that in patients in Group III (p < 0.004). In fact, the preoperative rCBF predicted whether a bypass would maintain CBO at a cutoff value of 24.5 to 25 ml/100 g/min. Among Groups I and II, 18 patients demonstrated an increase in deoxyhemoglobin during STA compression. The preoperative rCBF in these cases was lower than that in the six remaining patients (p < 0.006). Note that the preoperative rCBF predicted the postoperative deoxyhemoglobin response at a cutoff value of 22.2 to 24 ml/100 g/min. Conclusions. The EC—IC bypass surgery can maintain CBO immediately after surgery or gradually within 1 year when the preoperative rCBF is below 24.5 to 25 ml/100 g/min. Furthermore, bypass flow plays a critical role in maintaining an adequate CBO when preoperative rCBF is below 22.2 to 24 ml/100 g/min.


1998 ◽  
Vol 89 (3) ◽  
pp. 389-394 ◽  
Author(s):  
Peter J. Kirkpatrick ◽  
Joseph Lam ◽  
Pippa Al-Rawi ◽  
Piotr Smielewski ◽  
Marek Czosnyka

Object. Signal changes in adult extracranial tissues may have a profound effect on cerebral near-infrared spectroscopy (NIRS) measurements. During carotid surgery NIRS signals provide the opportunity to determine the relative contributions from the intra- and extracranial vascular territories, allowing for a more accurate quantification. In this study the authors applied multimodal monitoring methods to patients undergoing carotid endarterectomy and explored the hypothesis that NIRS can define thresholds for cerebral ischemia, provided extracranial NIRS signal changes are identified and removed. Relative criteria for intraoperative severe cerebral ischemia (SCI) were applied to 103 patients undergoing carotid endarterectomy. Methods. One hundred three patients underwent carotid endarterectomy. An intraoperative fall in transcranial Doppler—detected middle cerebral artery flow velocity (%ΔFV) of greater than 60% accompanied by a sustained fall in cortical electrical activity were adopted as criteria for SCI. Ipsilateral frontal NIRS recorded the total difference in concentrations of oxyhemoglobin and deoxyhemoglobin (Total ΔHbdiff). Interrupted time series analysis following clamping of the external carotid artery (ECA) and the internal carotid artery (ICA) allowed the different vascular components of Total ΔHbdiff (ECA ΔHbdiff and ICA ΔHbdiff) to be identified. Data obtained in 76 patients were deemed suitable. A good correlation between %ΔFV and ICA ΔHbdiff (r = 0.73, p < 0.0001) was evident. Sixteen patients (21%) fulfilled the criteria for SCI. All patients who demonstrated an ICA ΔHbdiff of greater than 6.8 µmol/L showed SCI, and in two patients within this group nondisabling watershed infarction developed, as seen on postoperative computerized tomography scans. No patient with an ICA ΔHbdiff less than 5 µmol/L exhibited SCI or suffered a stroke. Within the resolution of the criteria used an ICA ΔHbdiff threshold of 6.8 µmol/L provided 100% specificity for SCI, whereas an ICA ΔHbdiff less than 5 µmol/L was 100% sensitive for excluding SCI. When Total ΔHbdiff was used without removing the ECA component, no thresholds for SCI were apparent. Conclusions. Carotid endarterectomy provides a stable environment for exploring NIRS-quantified thresholds for SCI in the adult head.


2012 ◽  
Vol 19 (3) ◽  
pp. 232-236
Author(s):  
Ilona Šuškevičienė ◽  
Danguolė ČeslavaRugytė ◽  
Tomas Bukauskas ◽  
Alina Vilkė ◽  
Diana Bilskienė ◽  
...  

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 


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.


2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Homajoun Maslehaty ◽  
Ulf Krause-Titz ◽  
Athanassios K. Petridis ◽  
Harald Barth ◽  
Hubertus Maximilian Mehdorn

Objective. The aim of our prospective study was to investigate the applicability and the diagnostic value of near-infrared spectroscopy (NIRS) in SAH patients using the cerebral oximeter INVOS 5100C. Methods. Measurement of cerebral oximetry was done continuously after spontaneous SAH. Decrease of regional oxygen saturation (rSO2) was analyzed and interpreted in view of the determined intrinsic and extrinsic factors. Changes of rSO2 values were matched with the values of ICP, tipO2, and TCD and the results of additional neuroimaging. Results. Continuous measurement of rSO2 was performed in nine patients with SAH (7 females and 2 males). Mean measurement time was 8.6 days (range 2–12 days). The clinical course was uneventful in 7 patients without occurrence of CVS. In these patients, NIRS measured constant and stable rSO2 values without relevant alterations. Special findings are demonstrated in 3 cases. Conclusion. Measurement of rSO2 with NIRS is a safe, easy to use, noninvasive additional measurement tool for cerebral oxygenation, which is used routinely during vascular and cardiac surgical procedures. NIRS is applicable over a long time period after SAH, especially in alert patients without invasive probes. Our observations were promising, whereby larger studies are needed to answer the open questions.


1999 ◽  
Vol 88 (3) ◽  
pp. 554-558 ◽  
Author(s):  
A. Timothy Lovell ◽  
Huw Owen-Reece ◽  
Clare E. Elwell ◽  
Martin Smith ◽  
John C. Goldstone

2006 ◽  
Vol 59 (3) ◽  
pp. 462-465 ◽  
Author(s):  
Nicole Nagdyman ◽  
Thilo Fleck ◽  
Birgit Bitterling ◽  
Peter Ewert ◽  
Hashim Abdul-Khaliq ◽  
...  

Neonatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Bi Ze ◽  
Lili Liu ◽  
Ge Sang Yang Jin ◽  
Minna Shan ◽  
Yuehang Geng ◽  
...  

<b><i>Background:</i></b> Accurate detection of cerebral oxygen saturation (rSO<sub>2</sub>) may be useful for neonatal brain injury prevention, and the normal range of rSO<sub>2</sub> of neonates at high altitude remained unclear. <b><i>Objective:</i></b> To compare cerebral rSO<sub>2</sub> and cerebral fractional tissue oxygen extraction (cFTOE) at high-altitude and low-altitude areas in healthy neonates and neonates with underlying diseases. <b><i>Methods:</i></b> 515 neonates from low-altitude areas and 151 from Tibet were enrolled. These neonates were assigned into the normal group, hypoxic-ischemic encephalopathy (HIE) group, and other diseases group. Near-infrared spectroscopy was used to measure rSO<sub>2</sub> in neonates within 24 h after admission. The differences of rSO<sub>2</sub>, pulse oxygen saturation (SpO<sub>2</sub>), and cFTOE levels were compared between neonates from low- and high-altitude areas. <b><i>Results:</i></b> (1) The mean rSO<sub>2</sub> and cFTOE levels in normal neonates from Tibet were 55.0 ± 6.4% and 32.6 ± 8.5%, significantly lower than those from low-altitude areas (<i>p</i> &#x3c; 0.05). (2) At high altitude, neonates with HIE, pneumonia (<i>p</i> &#x3c; 0.05), anemia, and congenital heart disease (<i>p</i> &#x3c; 0.05) have higher cFTOE than healthy neonates. (3) Compared with HIE neonates from plain areas, neonates with HIE at higher altitude had lower cFTOE (<i>p</i> &#x3c; 0.05), while neonates with heart disease in plateau areas had higher cFTOE than those in plain areas (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The rSO<sub>2</sub> and cFTOE levels in normal neonates from high-altitude areas are lower than neonates from the low-altitude areas. Lower cFTOE is possibly because of an increase in blood flow to the brain, and this may be adversely affected by disease states which may increase the risk of brain injury.


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