Cerebral Oxygenation During Defibrillator Threshold Testing of Implantable Cardioverter Defibrillators

McNeill, Elizabeth; Gagnon, R.; Potts, James E.; Yeung‐Lai‐Wah, John A.; Kerr, Charles R.; Sanatani, Shubhayan

doi:10.1111/j.1540-8159.2005.09518.x

Cited by 8 publications

(6 citation statements)

References 36 publications

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“…The NIRO 300 instrument has overall been shown to produce valid measurements of the oxCCO signal. 20,[45][46][47][48][49][50][51][52][53] However, it belongs to those early-generation instruments that used only four discrete wavelengths (775, 810, 850, and 910 nm, respectively) to assess both the metabolic and hemodynamic signals. These wavelengths are in relatively good agreement with the optimal wavelengths reported for CCO measures.…”

Section: Discussionmentioning

confidence: 99%

Test–retest reliability of brain mitochondrial cytochrome-c-oxidase assessed by functional near-infrared spectroscopy

Holper

Mann

2018

J. Biomed. Opt.

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Test-retest reliability of brain mitochondrial cytochrome-c-oxidase assessed by functional near-infrared spectroscopy," J.Abstract. Functional near-infrared spectroscopy (fNIRS) is a noninvasive method for measuring in vivo both hemodynamic and mitochondrial metabolic activities in brain cortical structures. Although the test-retest reliability of the hemodynamic measures, such as reflected by oxygenated (HbO 2 ), deoxygenated (HHb) hemoglobin, and the tissue oxygenation index (TOI), has been previously reported to be good to excellent, the reliability of the metabolic signal indexed by oxidized cytochrome-c-oxidase (oxCCO) has not been reported. The present testretest study compared the reliability of the metabolic and hemodynamic signals in 10 healthy participants undergoing hypo-and hypercapnia challenges. The primary reliability measure was the intraclass correlation coefficient (ICC). Results of both hypo-and hypercapnia showed that the oxCCO signal (ICC ¼ 0.876∕0.757) had robust reliability comparable with that of the HbO 2 (ICC ¼ 0.841∕0.801), HHb (ICC ¼ 0.804∕0.571), and TOI (ICC ¼ 0.574∕0.614) signals. These findings show that the oxCCO signal can be assessed by fNIRS with comparable reliability to the hemodynamic measures. We discuss the results in light of current interest in a mitochondrial metabolic marker derived from fNIRS.

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Section: Discussionmentioning

confidence: 99%

Test–retest reliability of brain mitochondrial cytochrome-c-oxidase assessed by functional near-infrared spectroscopy

Holper

Mann

2018

J. Biomed. Opt.

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“… 20 Moderate ⊕⊕⊕◯ Critical False negative Moderate ⊕⊕⊕◯ Important POCUS cardiac motion assessment False positive 0 g (0) NA (no studies used IAP monitoring as reference test) No direct evidence or comparison with invasive arterial blood pressure monitoring. Very low ⊕◯◯◯ Critical False negative Very low ⊕◯◯◯ Important NIRS False positive 3 g (30) 1 case series 23 2 prospective cohort 27 , 28 No rSO 2 threshold has been suggested in the literature. Two studies have shown correlation between rSO 2 and perfusion 23 , 27 In one observational study ( n = 6), the absolute rSO2 value at the moment death had a broad range.…”

Section: Resultsmentioning

confidence: 99%

“… 23 Indirect evidence is from one reported case ( n = 1, Slavin et al . ), 24 two case-control studies, 25 , 26 two observational studies during defibrillator implantation, 27 , 28 and one pediatric study. 29 No measures of diagnostic accuracy were reported and no threshold for NIRS was suggested.…”

Section: Resultsmentioning

confidence: 99%

Diagnostic test accuracy for cessation of circulation during death determination: a systematic review

Klowak

Nguyen

Malik

et al. 2023

Can J Anesth/J Can Anesth

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Purpose To synthesize the available evidence comparing noninvasive methods of measuring the cessation of circulation in patients who are potential organ donors undergoing death determination by circulatory criteria (DCC) with the current accepted standard of invasive arterial blood pressure (IAP) monitoring. Source We searched (from inception until 27 April 2021) MEDLINE, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. We screened citations and manuscripts independently and in duplicate for eligible studies that compared noninvasive methodologies assessing circulation in patients who were monitored around a period of cessation of circulation. We performed risk of bias assessment, data abstraction, and quality assessment using Grading of Recommendations, Assessment, Development, and Evaluation in duplicate and independently. We presented findings narratively. Principal findings We included 21 eligible studies ( N = 1,177 patients). Meta-analysis was not possible because of study heterogeneity. We identified low quality evidence from four indirect studies ( n = 89) showing pulse palpation is less sensitive and specific than IAP (reported sensitivity range, 0.76–0.90; specificity, 0.41–0.79). Isoelectric electrocardiogram (ECG) had excellent specificity for death (two studies; 0% [0/510]), but likely increases the average time to death determination (moderate quality evidence). We are uncertain whether point-of-care ultrasound (POCUS) pulse check, cerebral near-infrared spectroscopy (NIRS), or POCUS cardiac motion assessment are accurate tests for the determination of circulatory cessation (very low-quality evidence). Conclusion There is insufficient evidence that ECG, POCUS pulse check, cerebral NIRS, or POCUS cardiac motion assessment are superior or equivalent to IAP for DCC in the setting of organ donation. Isoelectric ECG is specific but can increase the time needed to determine death. Point-of-care ultrasound techniques are emerging therapies with promising initial data but are limited by indirectness and imprecision. Study registration PROSPERO (CRD42021258936); first submitted 16 June 2021. Supplementary Information The online version contains supplementary material available at 10.1007/s12630-023-02424-3.

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“…There was only one report of using NIRS to study cytochrome c oxidase in humans. It showed that there were no significant changes in redox status during the brief period of ischemia that occurs during surgical cardiac defibrillator replacement [35]. Two swine studies sought to gain insight into the differences in cytochrome redox status results seen between previous investigators.…”

Section: Recent Advancesmentioning

confidence: 99%

Near Infrared Spectroscopy (NIRS) in the clinical setting – An adjunct to monitoring during diagnosis and treatment

Gagnon

Macnab

2005

Journal of Spectroscopy

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Since clinical near infrared spectrophotometers (NIRS) first became commercially available in the early 1990's there have been more than two thousand related peer reviewed reports in the medical literature. These encompass a wide range of human and animal trials that have been directed at validating the principles, methods, and algorithms underlying the technology, as well as demonstrating its potential for specific clinical uses such as detecting concealed bleeding, onset of hypoxia, progress of ischemia, and tissue oxygenation status within human brain, muscles, organs, and tumours. In addition to its standard use as a monitor of patterns of change in the concentrations of oxygenated, and de-oxygenated hemoglobin residing in blood, NIRS has also been used to monitor patterns of change in the redox status of the cellular respiration enzyme, cytochrome c oxidase (Cyt a,a3) which utilizes the oxygen diffused from the blood. Accompanied by a tracer bolus of near infrared absorbing dye, NIRS has also been used to measure the proportional blood flow and blood volume transiting organs. NIRS has been used in conjunction with PET, fMRI, BOLD-fMRI, TCD, vascular flowmetry, MRS, NMR, plethysmography, PO2histography, EEG, ECG, EMG, SSEP, MEP, MEG, and standard bedside monitoring devices. Herein we summarize the history, technique, algorithms, methods and advances of clinical NIRS.

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Cerebral Oxygenation During Defibrillator Threshold Testing of Implantable Cardioverter Defibrillators

Abstract: Our results suggest that impaired oxygen delivery during induced VF and VT does not affect oxygen availability at the cellular intra-mitochondrial level.

Cited by 8 publications

References 36 publications

Test–retest reliability of brain mitochondrial cytochrome-c-oxidase assessed by functional near-infrared spectroscopy

Test–retest reliability of brain mitochondrial cytochrome-c-oxidase assessed by functional near-infrared spectroscopy

Diagnostic test accuracy for cessation of circulation during death determination: a systematic review

Near Infrared Spectroscopy (NIRS) in the clinical setting – An adjunct to monitoring during diagnosis and treatment

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