A Method to Calculate Arterial and Venous Saturation from Near Infrared Spectroscopy (Nirs)

Menssen, Jan; Colier, Willy N.J.M.; Hopman, J.C.W.; Liem, Djien; Korte, Chris L. de

doi:10.1007/978-0-387-85998-9_21

Cited by 18 publications

(15 citation statements)

References 9 publications

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“…NIRS was also combined with measurements of oscillatory blood volume changes induced by spontaneous respiration78,79 or during mechanical ventilation,80 assuming that the oscillatory components of blood volume changes at the breathing rate are mostly of venous origin.…”

Section: Venous Blood Oxygen Saturationmentioning

confidence: 99%

Pulse oximetry: fundamentals and technology update

Nitzan

Romem

Koppel

2014

MDER

301

252

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Oxygen saturation in the arterial blood (SaO2) provides information on the adequacy of respiratory function. SaO2 can be assessed noninvasively by pulse oximetry, which is based on photoplethysmographic pulses in two wavelengths, generally in the red and infrared regions. The calibration of the measured photoplethysmographic signals is performed empirically for each type of commercial pulse-oximeter sensor, utilizing in vitro measurement of SaO2 in extracted arterial blood by means of co-oximetry. Due to the discrepancy between the measurement of SaO2 by pulse oximetry and the invasive technique, the former is denoted as SpO2. Manufacturers of pulse oximeters generally claim an accuracy of 2%, evaluated by the standard deviation (SD) of the differences between SpO2 and SaO2, measured simultaneously in healthy subjects. However, an SD of 2% reflects an expected error of 4% (two SDs) or more in 5% of the examinations, which is in accordance with an error of 3%–4%, reported in clinical studies. This level of accuracy is sufficient for the detection of a significant decline in respiratory function in patients, and pulse oximetry has been accepted as a reliable technique for that purpose. The accuracy of SpO2 measurement is insufficient in several situations, such as critically ill patients receiving supplemental oxygen, and can be hazardous if it leads to elevated values of oxygen partial pressure in blood. In particular, preterm newborns are vulnerable to retinopathy of prematurity induced by high oxygen concentration in the blood. The low accuracy of SpO2 measurement in critically ill patients and newborns can be attributed to the empirical calibration process, which is performed on healthy volunteers. Other limitations of pulse oximetry include the presence of dyshemoglobins, which has been addressed by multiwavelength pulse oximetry, as well as low perfusion and motion artifacts that are partially rectified by sophisticated algorithms and also by reflection pulse oximetry.

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Section: Venous Blood Oxygen Saturationmentioning

confidence: 99%

Pulse oximetry: fundamentals and technology update

Nitzan

Romem

Koppel

2014

MDER

301

252

View full text Add to dashboard Cite

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“…skin, subcutaneous tissue). Conversely, frequency domain analysis of NIRS signals may allow for NIRS equipment to separately analyze arterial and venous saturations, and thus estimate the relative contributions of arterial and venous blood in particular organs [29].…”

Section: Discussionmentioning

confidence: 99%

Non-invasive estimation of jugular venous oxygen saturation: a comparison between near infrared spectroscopy and transcutaneous venous oximetry

Colquhoun

Tucker-Schwartz

Durieux

et al. 2012

J Clin Monit Comput

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The ability of practitioners to assess the adequacy of global oxygen delivery is dependent on an accurate measurement of central venous saturation. Traditional techniques require the placement of invasive central venous access devices. This study aimed to compare two non-invasive technologies for the estimation of regional venous saturation (reflectance plethysmography and near infrared spectroscopy [NIRS]), using venous blood gas analysis as gold standard. Forty patients undergoing cardiac surgery were recruited in two groups. In the first group a reflectance pulse oximeter probe was placed on the skin overlying the internal jugular vein. In the second group, a Somanetics INVOS oximeter patch was placed on the skin overlying the internal jugular vein and overlying the ipsilateral cerebral hemisphere. Central venous catheters were placed in all patients. Oxygen saturation estimates from both groups were compared with measured saturation from venous blood. Twenty patients participated in each group.Data were analyzed by the limits of agreement technique suggested by Bland and Altman and by linear regression analysis. In the reflectance plethysmography group, the mean bias was 4.27% and the limits of agreement were 58.3 to -49.8% (r(2) = 0.00, p = 0.98). In the NIRS group the mean biases were 10.8% and 2.0% for the sensors attached over the cerebral hemisphere and over the internal jugular vein, respectively, and the limits of agreement were 33.1 to -11.4 and 19.5 to -15.5% (r(2) = 0.22, 0.28;p = 0.04, 0.03) for the cerebral hemisphere and internal jugular sites, respectively. While transcutaneous regional oximetry and NIRS have both been used to estimate venous and tissue oxygen saturation non-invasively, the correlation between estimates of ScvO(2) and SxvO(2) were statistically significant for near infrared spectroscopy, but not for transcutaneous regional oximetry. Placement of cerebral oximetry patches directly over the internal jugular vein (as opposed to on the forehead) appeared to approximate internal jugular venous saturation better (lower mean bias and tighter limits of agreement), which suggests this modality may with refinement offer the practitioner additional clinically useful information regarding global cerebral oxygen supply and demand matching.

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“…Our analysis focused on variation of HbO 2 and HbTot, as estimate of CBF,9 10 and of the ratio between HbO 2 and HbTot (HbO 2 /HbTot), as estimate of cerebral oxygenation 11. Signal components possibly related to physiological noise or movement were removed by filtering the NIR signal 8…”

Section: Methodsmentioning

confidence: 99%