Cerebral and tissue oximetry

Steppan, Jochen; Hogue, Charles W.

doi:10.1016/j.bpa.2014.09.002

Cited by 109 publications

(96 citation statements)

References 94 publications

(99 reference statements)

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“…Regional oxygen saturation (rSO 2 ) reflects the balance between the tissues’ oxygen requirements and actual tissue oxygenation. It also reflects the microcirculation of arterial, venous, and capillary networks: 75–85% of the signal comes from venules (8–11). NIRS is interesting for detecting subclinical hypoperfusion (microcirculatory dysfunctions).…”

Section: Introductionmentioning

confidence: 99%

Monitoring Cerebral and Renal Oxygenation Status during Neonatal Digestive Surgeries Using Near Infrared Spectroscopy

Beck¹,

Loron²,

Masson

et al. 2017

Front. Pediatr.

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BackgroundDepending on the initial pathology, hypovolemia, intra-abdominal hypertension, and sepsis are often encountered in neonatal digestive surgery. Accurate newborn monitoring during and after surgery is essential to adapt resuscitation protocols. Near infrared spectroscopy (NIRS) is non-invasive and can detect hypoperfusion which indicates a low circulatory blood flow, regardless of the cause.ObjectiveEvaluating changes in cerebral and renal regional oxygen saturation during neonatal digestive surgeries, conducted according to normal practices, with commonly used monitoring parameters. Analyzing retrospectively the inter-relationships between NIRS values and mean arterial pressure (MAP) values as well as pre-ductal SpO2.MethodsProspective, descriptive, monocentric study. All neonates referred for surgery were included. NIRS allows the measurement of cerebral and renal oxygenation fluctuations, as well as calculating difference in intraoperative and postoperative values.ResultsNineteen patients were included. Cerebral regional oxygen saturation (C rSO2) values were stable while renal regional oxygen saturation (R rSO2) values tended to decrease with time during surgery. Indeed, 72% of rSO2 decline episodes occurred after the first 30 min of surgery, without any significant statistical differences for the next 90 min of surgery. After surgery, the lowest average C and R rSO2 values were evidenced during the first 6 h, with 60% of C rSO2 and R rSO2 anomalies occurring in that time frame. There was no significant statistical difference observed in the following 18 h. There was a significant correlation between R rSO2 and SpO2 values (p < 0.01), but not with C rSO2 values. There was no correlation with the MAP either for the C rSO2 values or R rSO2 ones.ConclusionNIRS is a promising non-invasive bedside tool to monitor cerebral and tissue perfusion, analyzing tissue microcirculation. NIRS has its interest to guide neonatal digestive surgeries (bowel manipulation, viscera reduction) and may represent an early warning for identifying patients requiring resuscitation during or after these surgeries.

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Section: Introductionmentioning

confidence: 99%

Monitoring Cerebral and Renal Oxygenation Status during Neonatal Digestive Surgeries Using Near Infrared Spectroscopy

Beck¹,

Loron²,

Masson

et al. 2017

Front. Pediatr.

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“…Non-invasive imaging in deep tissue requires a near-infrared CCD camera with strong sensitivity and high spatial resolution. By adding detectors at multiple distances from the emitted light source, specific algorithms can subtract superficial light absorption from deep absorption to provide qualitative information of the cystic fluid Hb level (11). Despite these limitations, there is a great need to develop a clinically useful, noninvasive and reliable tool that accurately predicts the malignant transformation of endometriosis.…”

Section: Discussionmentioning

confidence: 99%

“…Optical spectroscopy and tomography utilize the near-infrared spectral region to provide quantitative determination of several important biological chromophores, such as Hb (11) or cytochrome c oxidase (12). Furthermore, light in the near-infrared spectrum efficiently penetrates tissue, including bone and muscle (11).…”

Section: Introductionmentioning

confidence: 99%

Discrimination of malignant transformation from benign endometriosis using a near‑infrared approach

et al. 2018

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Abstract. The aim of the present single-center retrospective study was to investigate the discrimination of malignant transformation from ovarian endometrioma (OE) using a near-infrared approach ex vivo. Cystic fluid samples were collected from patients with OE (n=34) and endometriosis-associated ovarian cancer (EAOC) (n=12). The light reflected from each sample of cystic fluid [change in luminance, Δl (cd/m 2 ) = background luminance-cystic fluid luminance at 800 nm] was spectrally measured by a near-infrared CCD camera with band-path filter (800 nm). The Δl in EAOC was significantly lower compared with that in OE. On regression analysis, a positive correlation was observed between the Δl and Hb level in the cystic fluid, and this association was exponential. The diagnostic sensitivity and specificity of Δl was 83.3 and 94.1% at the cutoff value of 21.5 cd/m 2 , with an area under the ROC curve of 0.897. The present ex vivo study potentially provides a powerful near-infrared approach for quantitative discrimination between EAOC and benign OE, with high sensitivity and specificity, which may have clinical applications.

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“…All devices report regional oxygen saturation (rSO 2 ) of the tissue beneath the sensor based on near infrared spectroscopy, the technical aspects of which are reported elsewhere [14, 15]. Two monitors were tested per subject with one INVOS sensor (SAFB-SM) on the left side of the forehead, and either an EQUANOX (8000CA or 8004CA) or FORE-SIGHT (standard large, medium, or small) sensor on the right, placed 2 cm apart if possible (Fig.…”

Section: Methodsmentioning

confidence: 99%

Detection of critical cerebral desaturation thresholds by three regional oximeters during hypoxia: a pilot study in healthy volunteers

2017

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BackgroundRegional oximetry is increasingly used to monitor post-extraction oxygen status of the brain during surgical procedures where hemodynamic fluctuations are expected. Particularly in cardiac surgery, clinicians employ an interventional algorithm to restore baseline regional oxygen saturation (rSO2) when a patient reaches a critical desaturation threshold. Evidence suggests that monitoring cardiac surgery patients and intervening to maintain rSO2 can improve postoperative outcomes; however, evidence generated with one manufacturer’s device may not be applicable to others. We hypothesized that regional oximeters from different manufacturers respond uniquely to changes in oxygen saturation in healthy volunteers.MethodsThree devices were tested: INVOS™ 5100C (Medtronic), EQUANOX™ 7600 (Nonin), and FORE-SIGHT™ (CASMED) monitors. We divided ten healthy subjects into two cohorts wearing a single sensor each from INVOS and EQUANOX (n = 6), or INVOS and FORE-SIGHT (n = 4). We induced and reversed hypoxia by adjusting the fraction of inspired oxygen. We calculated the magnitude of absolute rSO2 change and rate of rSO2 change during desaturation and resaturation, and determined if and when each device reached a critical interventional rSO2 threshold during hypoxia.ResultsAll devices responded to changes in oxygen directionally as expected. The median absolute rSO2 change and the rate of rSO2 change was significantly greater during desaturation and resaturation for INVOS compared with EQUANOX (P = 0.04). A similar but nonsignificant trend was observed for INVOS compared with FORE-SIGHT; our study was underpowered to definitively conclude there was no difference. A 10% relative decrease in rSO2 during desaturation was detected by all three devices across the ten subjects. INVOS met a 20% relative decrease threshold in all subjects of both cohorts, compared to 1 with EQUANOX and 2 with FORE-SIGHT. Neither EQUANOX nor FORE-SIGHT reached a 50% absolute rSO2 threshold compared with 4 and 3 subjects in each cohort with INVOS, respectively.ConclusionsSignificant differences exist between the devices in how they respond to changes in oxygen saturation in healthy volunteers. We suggest caution when applying evidence generated with one manufacturer’s device to all devices.Electronic supplementary materialThe online version of this article (doi:10.1186/s12871-016-0298-7) contains supplementary material, which is available to authorized users.

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Cerebral and tissue oximetry

Cited by 109 publications

References 94 publications

Monitoring Cerebral and Renal Oxygenation Status during Neonatal Digestive Surgeries Using Near Infrared Spectroscopy

Monitoring Cerebral and Renal Oxygenation Status during Neonatal Digestive Surgeries Using Near Infrared Spectroscopy

Discrimination of malignant transformation from benign endometriosis using a near‑infrared approach

Detection of critical cerebral desaturation thresholds by three regional oximeters during hypoxia: a pilot study in healthy volunteers

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