Nahinfrarotspektroskopie unter kardiopulmonaler Reanimation und mechanischer Kreislaufunterstützung

Wally, D.; Velik‐Salchner, Corinna

doi:10.1007/s00063-015-0012-4

Cited by 4 publications

(3 citation statements)

References 72 publications

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“…So far, diagnostic options for the monitoring of lower limb perfusion and detecting signs of possible ischemia are limited to clinical examination, monitoring of tissue oxygen saturation with NIRS and color-coded duplex ultrasonography [ 12 , 22 – 24 ]. Moreover, NIRS skin measurements might be less sensitive for the detection of early onset leg ischemia [ 20 , 25 ]. We detected similar SWE parameters of the gastrocnemius muscles on both legs (cannulated side and cannula-free side) at rest, regardless of the presence or absence of a DPC.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of skin tissue oxygen saturation offers the possibility to continuously monitor limb and cerebral perfusion. However, NIRS is limited in its relatively low diagnostic accuracy, specifically in cases of hyperbilirubinemia or elevated levels of myoglobin [ 20 , 25 ]. Vranken et al examined changes in cerebral and peripheral tissue oximetry in patients with VA-ECMO and different complications such as neurological complications or limb ischemia with the necessity for DPC.…”

Section: Discussionmentioning

confidence: 99%

“…NIRS measurements were recorded via self-adhesive electrodes, using an INVOS-Monitor (Medtronic, Minneapolis, USA). NIRS-values above 50% were considered satisfactory with respect to tissue oxygenation according to the local hospital standards [ 20 ]. All NIRS measurements were electronically transferred to the patient data management system.…”

Section: Methodsmentioning

confidence: 99%

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Muscle ultrasound shear wave elastography for detection of early onset lower limb ischemia in patients with veno-arterial extracorporeal membrane oxygenation

Maslarska,

Piepenburg,

Westermann

et al. 2023

ICMx

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Background and objectives Limb ischemia or compartment syndrome, requiring surgery, are some of the frequent cannula-related complications in patients supported with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). The purpose of this exploratory study is to depict and evaluate the dynamic changes in the lower limb muscles with ultrasound shear wave elastography as marker for early lower limb ischemia. Methods Eleven patients with VA-ECMO after cardiac arrest were included in this study. Seven patients received distal perfusion cannula (DPC) after implantation of the VA-ECMO, whereas 4 had no DPC after VA-ECMO. Compartment syndrome was clinically excluded in all patients. Both lower limbs, e.g., with and without arterial cannula, were monitored with near-infrared spectroscopy (NIRS) for the oxygen saturation of the local tissue. We performed ultrasound shear wave elastrography (SWE) to assess dynamic changes of the medial gastrocnemius muscle at maximum passive muscle stretch (exercise) of both legs. Color-coded duplexsonography was conducted to examine the blood flow velocity of the popliteal artery of the lower limb. Results We found no difference between DPC and no DPC (p = 0.115) during use of VA-ECMO. However, we detected marked lower limb muscle perfusion deficits of cannulated (58.9 ± 13.5 kPa) vs. cannula-free limb (95.7 ± 27.9 kPa: p < 0.001), applying SWE. No relationship was detected between NIRS measurements and SWE values (kPa) of both lower limbs. The mean peak systolic velocity of the popliteal artery at the cannulated side (30.0 ± 11.7 cm/s) was reduced compared to the non-cannulated side (39.3 ± 18.6 cm/s; p = 0.054). Conclusions Regardless of DPC after implantation of VA-ECMO, the gastrocnemius muscles seem to lose function due to cannula-related microcirculatory deficits. Muscle function analysis via SWE combined with NIRS might offer a sensitive indicator for early onset leg ischemia during VA-ECMO-related arterial cannulation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Muscle ultrasound shear wave elastography for detection of early onset lower limb ischemia in patients with veno-arterial extracorporeal membrane oxygenation

Maslarska,

Piepenburg,

Westermann

et al. 2023

ICMx

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Monitoring of cerebral oxygenation

Rahma,

Lopa,

Mukherjee

et al. 2024

The Brain of the Critically Ill Pregnant Woman

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Assessment of intraventricular hemorrhage risk in preterm infants using mathematically simulated cerebral blood flow

Sidorenko,

Brodkorb,

Felderhoff-Müser

et al. 2024

Front. Neurol.

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Intraventricular hemorrhage (IVH)4 is one of the most threatening neurological complications associated with preterm birth which can lead to long-term sequela such as cerebral palsy. Early recognition of IVH risk may prevent its occurrence and/or reduce its severity. Using multivariate logistic regression analysis, risk factors significantly associated with IVH were identified and integrated into risk scales. A special aspect of this study was the inclusion of mathematically calculated cerebral blood flow (CBF) as an independent predictive variable in the risk score. Statistical analysis was based on clinical data from 254 preterm infants with gestational age between 23 and 30 weeks of pregnancy. Several risk scores were developed for different clinical situations. Their efficacy was tested using ROC analysis, and validation of the best scores was performed on an independent cohort of 63 preterm infants with equivalent gestational age. The inclusion of routinely measured clinical parameters significantly improved IVH prediction compared to models that included only obstetric parameters and medical diagnoses. In addition, risk assessment with numerically calculated CBF demonstrated higher predictive power than risk assessments based on standard clinical parameters alone. The best performance in the validation cohort (with AUC = 0.85 and TPR = 0.94 for severe IVH, AUC = 0.79 and TPR = 0.75 for all IVH grades and FPR = 0.48 for cases without IVH) was demonstrated by the risk score based on the MAP, pH, CRP, CBF and leukocytes count.

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Nahinfrarotspektroskopie unter kardiopulmonaler Reanimation und mechanischer Kreislaufunterstützung

Cited by 4 publications

References 72 publications

Muscle ultrasound shear wave elastography for detection of early onset lower limb ischemia in patients with veno-arterial extracorporeal membrane oxygenation

Muscle ultrasound shear wave elastography for detection of early onset lower limb ischemia in patients with veno-arterial extracorporeal membrane oxygenation

Monitoring of cerebral oxygenation

Assessment of intraventricular hemorrhage risk in preterm infants using mathematically simulated cerebral blood flow

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