Clinical experience with transcranial cerebral oximetry

Slavin, Konstantin V.; Dujovny, Manuel; Ausman, James I.; Hernandez, Gerardo; Luer, Mark S.; Stoddart, Hugh

doi:10.1016/0090-3019(94)90084-1

Cited by 39 publications

(5 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Near infrared spectroscopy used in this study has 2 sensors that subtract the optical absorption of the superficial areas from the deep areas [14-16] and are known to show a mean of rSO 2 of 68 ± 5.6% in normal adults and no difference regarding age and sex [17]. …”

Section: Discussionmentioning

confidence: 99%

The Change in Regional Cerebral Oxygen Saturation after Stellate Ganglion Block

et al. 2010

View full text Add to dashboard Cite

BackgroundStellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation (rSO2). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy.MethodsSGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB.ResultsThe increments of the rSO2 on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The rSO2 on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes.ConclusionsWe observed an increment of the rSO2 on the block side from the baseline; however, the rSO2 on the non-block side decreased.

show abstract

Section: Discussionmentioning

confidence: 99%

The Change in Regional Cerebral Oxygen Saturation after Stellate Ganglion Block

et al. 2010

View full text Add to dashboard Cite

show abstract

“… 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

View full text Add to dashboard Cite

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.

show abstract

“…A previous experimental study, in which changes in CBF and tissue oxygen tension with transorbital MCA occlusion were continuously monitored in the MCA area of rabbits, indicated that collateral circulation developed promptly within 5 minutes after the start of ischemia 19 ; the tracer was thus injected at 5 minutes after the start of BTO in the present study. As a simple yet reliable technique for monitoring altered CBF or oxygenation of the brain, rSO 2 monitoring by measurement of NIRS with the INVOS 3100 13,14,20 or other instruments 21 has been used during skull base surgery, removal of a cervical tumor involving the carotid artery, and carotid endarterectomy. The sensor for the INVOS 3100 consists of a flexible pad (8.8ϫ4.4 cm) with 1 light source and 2 photodetectors.…”

Section: Discussionmentioning

confidence: 99%

An Additional Monitoring of Regional Cerebral Oxygen Saturation to HMPAO SPECT Study During Balloon Test Occlusion

Kaminogo

Ochi

Onizuka

et al. 1999

Stroke

View full text Add to dashboard Cite

Background and Purpose-To increase the reliability of 99m Tc-hexamethyl propyleneamine oxime (HMPAO) single photon emission computed tomography (SPECT) study in the evaluation of hemodynamic change with balloon test occlusion (BTO) of the internal carotid artery, we attempted to clarify the usefulness of additional monitoring of regional oxygen saturation of the brain (rSO 2 ). Methods-During BTO, rSO 2 monitoring with transcranial near infrared spectroscopy was performed 17 times on 16 patients. Asymmetrical distribution of the tracer was classified visually as follows: group 1, little or no asymmetry, and group 2, moderate or severe asymmetry. Seven regions of interest (ROI) were defined in the middle cerebral artery area of each hemisphere, and the asymmetry index (AI)ϭ200ϫ(C non ϪC occl )/(C non ϩC occl) ), where C non ϭmean counts on the nonoccluded side, and C occl ϭmean counts on the occluded side were also calculated. Then, mean AI (MAI) was obtained from AI of 7 ROIs for each study. Results-Of the 17 procedures, 10 BTOs were in group 1 and 5 BTOs were in group 2. Two patients did not undergo SPECT study because of the immediate appearance of a neurological deficit with BTO; they were defined as group 3. The MAI in group 1 was 2.6Ϯ3.3%, which was significantly smaller than the MAI in group 2 (25.6Ϯ5.0%, PϽ0.02).The ⌬rSO 2 (baseline rSO 2 ϪrSO 2 during ICA occlusion) with BTO in group 1 was 1.5Ϯ1.4% (nϭ10), which was statistically smaller than that in group 2 (5.5Ϯ1.3%, nϭ4, PϽ0.05). The ⌬rSO 2 in group 3 was 9.0Ϯ0.0% (nϭ2). In group 1, however, rSO 2 began to decline when the stump pressure fell to 45 mm Hg and always declined when the stump pressure fell below 40 mm Hg. Furthermore, in group 1, a significant correlation was observed between the ⌬rSO 2 and stump pressure (rϭ0.85, PϽ0.0001). Conclusions-This preliminary study reveals that an obvious asymmetrical SPECT pattern always accompanies a profound decrease in rSO 2 and that rSO 2 parallels a severe reduction in stump pressure in cases exhibiting a symmetrical SPECT pattern. Thus, the cerebral oximetry sensitively reflects the cerebral oxygenation, and simultaneous measurements of rSO 2 and stump pressure with 99m Tc-HMPAO SPECT study apparently are useful in evaluating hemodynamic integrity with BTO. (Stroke. 1999;30:407-413.)

show abstract

Clinical experience with transcranial cerebral oximetry

Cited by 39 publications

References 24 publications

The Change in Regional Cerebral Oxygen Saturation after Stellate Ganglion Block

The Change in Regional Cerebral Oxygen Saturation after Stellate Ganglion Block

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

An Additional Monitoring of Regional Cerebral Oxygen Saturation to HMPAO SPECT Study During Balloon Test Occlusion

Contact Info

Product

Resources

About