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

Tomlin, Kerry L.; Neitenbach, Anna-Maria; Borg, Ulf

doi:10.1186/s12871-016-0298-7

Cited by 20 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfortunately, each manufacturer's device responds differently to haemodynamic fluctuations. 32,33 Hence, study results obtained with one NIRS device might not be applicable when another NIRS device is being used, which might partially explain why the results from published studies are conflicting. Fourth, not all eligible patients were included, as there were few available NIRS devices.…”

Section: Discussionmentioning

confidence: 99%

Association between postoperative delirium and postoperative cerebral oxygen desaturation in older patients after cardiac surgery

Eertmans

Deyne

Genbrugge

et al. 2020

British Journal of Anaesthesia

View full text Add to dashboard Cite

Background: Near-infrared spectroscopy non-invasively measures regional cerebral oxygen saturation. Intraoperative cerebral desaturations have been associated with worse neurological outcomes. We investigated whether perioperative cerebral desaturations are associated with postoperative delirium in older patients after cardiac surgery. Methods: Patients aged 70 yr and older scheduled for on-pump cardiac surgery were included between 2015 and 2017 in a single-centre, prospective, observational study. Baseline cerebral oxygen saturation was measured 1 day before surgery. Throughout surgery and after ICU admission, cerebral oxygen saturation was monitored continuously up to 72 h after operation. The presence of delirium was assessed using the confusion assessment method for the ICU. Association with delirium was evaluated with unadjusted analyses and multivariable logistic regression. Results: Ninety-six of 103 patients were included, and 29 (30%) became delirious. Intraoperative cerebral oxygen saturation was not significantly associated with postoperative delirium. The lowest postoperative cerebral oxygen saturation was lower in patients who became delirious (P¼0.001). The absolute and relative postoperative cerebral oxygen saturation decreases were more marked in patients with delirium (13 [6]% and 19 [9]%, respectively) compared with patients without delirium (9 [4]% and 14 [5]%; P¼0.002 and P¼0.001, respectively). These differences in cerebral oxygen saturation were no longer present after excluding cerebral oxygen saturation values after patients became delirious. Older age, previous stroke, higher EuroSCORE II, lower preoperative Mini-Mental Status Examination, and more substantial absolute postoperative cerebral oxygen saturation decreases were independently associated with postoperative delirium incidence. Conclusions: Postoperative delirium in older patients undergoing cardiac surgery is associated with absolute decreases in postoperative cerebral oxygen saturation. These differences appear most detectable after the onset of delirium. Clinical trial registration: NCT02532530.

show abstract

Section: Discussionmentioning

confidence: 99%

Association between postoperative delirium and postoperative cerebral oxygen desaturation in older patients after cardiac surgery

Eertmans

Deyne

Genbrugge

et al. 2020

British Journal of Anaesthesia

View full text Add to dashboard Cite

show abstract

“…For direct comparisons of NIRS tissue oximeter models, caution is advised in interpreting the results when no comparative co-oximetry blood oxygen saturation reference (such as REF CX) is used as a control. One cannot determine which monitor is more accurate or has the more appropriate StO 2 value or rate of change [ 116 ] during an hypoxic or ischemia event without an appropriate comparative reference. Likewise, caution is advised in interpreting comparisons of different NIRS tissue oximeter models to blood oxygen saturation references different from that of the original NIRS tissue oximeter’s validation reference such as cerebral StO2 vs central or mixed venous SvO 2 [ 117 – 119 ].…”

Section: Discussionmentioning

confidence: 99%

A validation method for near-infrared spectroscopy based tissue oximeters for cerebral and somatic tissue oxygen saturation measurements

Benni¹,

MacLeod

Ikeda

et al. 2017

J Clin Monit Comput

View full text Add to dashboard Cite

We describe the validation methodology for the NIRS based FORE-SIGHT ELITE® (CAS Medical Systems, Inc., Branford, CT, USA) tissue oximeter for cerebral and somatic tissue oxygen saturation (StO2) measurements for adult subjects submitted to the United States Food and Drug Administration (FDA) to obtain clearance for clinical use. This validation methodology evolved from a history of NIRS validations in the literature and FDA recommended use of Deming regression and bootstrapping statistical validation methods. For cerebral validation, forehead cerebral StO2 measurements were compared to a weighted 70:30 reference (REF CXB) of co-oximeter internal jugular venous and arterial blood saturation of healthy adult subjects during a controlled hypoxia sequence, with a sensor placed on the forehead. For somatic validation, somatic StO2 measurements were compared to a weighted 70:30 reference (REF CXS) of co-oximetry central venous and arterial saturation values following a similar protocol, with sensors place on the flank, quadriceps muscle, and calf muscle. With informed consent, 25 subjects successfully completed the cerebral validation study. The bias and precision (1 SD) of cerebral StO2 compared to REF CXB was −0.14 ± 3.07%. With informed consent, 24 subjects successfully completed the somatic validation study. The bias and precision of somatic StO2 compared to REF CXS was 0.04 ± 4.22% from the average of flank, quadriceps, and calf StO2 measurements to best represent the global whole body REF CXS. The NIRS validation methods presented potentially provide a reliable means to test NIRS monitors and qualify them for clinical use.

show abstract

“…Increasing of age (months) and different sensors might be the reasons for the diversity of their results compared with our study. There are many commercially available NIRS devices on the market, and numerous studies [23][24][25][26][27] have compared the differences between them. The related results showed that there were significant differences between the devices in how they respond to changes in oxygen saturation, so caution should be used when applying evidence that was generated with one manufacturer's device to all devices.…”

Section: Discussionmentioning

confidence: 99%

Comparison of basic regional cerebral oxygen saturation values in patients of different ages: a pilot study

et al. 2020

View full text Add to dashboard Cite

Objective To explore the basic values of regional cerebral oxygen saturation (rSO2) among different age groups. Methods One hundred twenty patients who were scheduled for elective surgery aged 0 to 80 years (American Society of Anesthesiologists [ASA] physical status I or II) or neonates just after birth via cesarean section were enrolled and divided into the following six groups: infant (0 month and ≤12 months), toddler (>1 and ≤3 years old), preschool (>3 and ≤6 years old), school age (>6 and ≤18 years old), adult (>18 and ≤65 years old), and elderly (>65 and ≤80 years old) groups. There were 20 patients in each group. Results The basic values of rSO2 in infant, toddler, preschool, school age, adults, and elderly groups were 70.41% ± 4.66%, 72.43% ± 3.81%, 70.77% ± 3.27%, 70.62% ± 2.20%, 69.76% ± 6.02%, and 62.69% ± 3.14%, respectively. The basic value in the elderly group was lower compared with other five groups. There was no significant difference among infant, toddler, preschool age, school age, and adult groups. Conclusions The basic value of rSO2 in elderly patients is lower. Age is an important factor that affects the underlying value of rSO2.

show abstract

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

Cited by 20 publications

References 19 publications

Association between postoperative delirium and postoperative cerebral oxygen desaturation in older patients after cardiac surgery

Association between postoperative delirium and postoperative cerebral oxygen desaturation in older patients after cardiac surgery

A validation method for near-infrared spectroscopy based tissue oximeters for cerebral and somatic tissue oxygen saturation measurements

Comparison of basic regional cerebral oxygen saturation values in patients of different ages: a pilot study

Contact Info

Product

Resources

About