Near-infrared spectroscopy - not useful to monitor cerebral oxygenation after severe brain injury

Büchner, Karl-Heinz; Meixensberger, J.; Dings, J.; Roosen, K.

doi:10.1055/s-2000-8262

Cited by 45 publications

(36 citation statements)

References 15 publications

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“…As well, because of the cost effectiveness, portability, and ease of use of NIRS, it is an attractive noninvasive technique for evaluating cerebral function in a variety of experimental conditions and settings. Several investigators have used NIRS to evaluate cerebral oxygenation and blood volume changes in patients with neurological disorders, including traumatic brain injury (TBI) [17][18][19][20], stroke [21], brain tumors [22][23], and cerebral ischemia [23]. The clinical application of NIRS in patients with severe acute TBI has indicated that the technique must be used cautiously because of its limited sensitivity [18] and oscillations that are observed in the oxyHb signal [19].…”

Section: Introductionmentioning

confidence: 99%

Reliability of near-infrared spectroscopy measures of cerebral oxygenation and blood volume during handgrip exercise in nondisabled and traumatic brain-injured subjects

Bhambhani¹,

Maikala²,

Farag³

et al. 2006

JRRD

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Abstract-We compared the test-retest reliability of nearinfrared spectroscopy (NIRS) measures of cerebral oxygenation and blood volume during a rhythmic handgrip exercise in 13 nondisabled subjects and 25 subjects with moderate to severe traumatic brain injury (TBI). Subjects with TBI (average Glasgow Coma Scale score = 4.2, average time since injury = 21 mo) had completed an acute brain injury rehabilitation program. After 2 min of rest, each subject performed 60 s of maximal rhythmic handgrip contractions with the right hand in two trials 24 to 48 h apart. We used NIRS to measure cerebral oxygenation and blood volume responses from the left prefrontal lobe. Both groups' cerebral oxygenation and blood volume increased during handgrip contractions. The change in cerebral oxygenation was significantly lower in subjects with TBI compared with nondisabled subjects. Intraclass correlations between the two trials for cerebral oxygenation and blood volume were 0.83 and 0.80, respectively, in nondisabled subjects and 0.70 and 0.64, respectively, in subjects with TBI. The findings indicate that NIRS is a reliable noninvasive technique for evaluating cerebral oxygenation and blood volume changes during motor function. NIRS can be useful in monitoring recovery of cerebral oxygenation during rehabilitation of patients with TBI.

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Section: Introductionmentioning

confidence: 99%

Reliability of near-infrared spectroscopy measures of cerebral oxygenation and blood volume during handgrip exercise in nondisabled and traumatic brain-injured subjects

Bhambhani¹,

Maikala²,

Farag³

et al. 2006

JRRD

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“…8 -10 However, their accuracy remains controversial, and to date they have not achieved regular clinical use. 11,12 The theory behind NIRS has been described in detail previously. 13 When one measures from the adult head, changes in hemoglobin chromophore concentrations are derived from a composite block of illuminated tissue.…”

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confidence: 99%

Evaluation of a Near-Infrared Spectrometer (NIRO 300) for the Detection of Intracranial Oxygenation Changes in the Adult Head

Al-Rawi¹,

Smielewski²,

Kirkpatrick³

2001

Stroke

246

159

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Background and Purpose-The clinical application of intracranial near-infrared spectroscopy in adults has been hampered by concerns over contamination from extracranial tissues. The NIRO 300 (Hamamatsu Photonics) provides continuous online measurements of hemoglobin and cytochrome oxidase concentrations and a calculated tissue oxygen index (TOI). The present study seeks confirmation of the anatomic source of TOI in the adult cranium. Methods-Sixty patients undergoing carotid endarterectomy were studied. The NIRO 300 was incorporated into an established multimodal monitoring system. TOI, oxyhemoglobin, and deoxyhemoglobin changes were assessed and compared with (1) frontal cutaneous laser-Doppler flowmetry and (2) transcranial Doppler measurement of the ipsilateral middle cerebral artery flow velocity. Results-Changes in TOI were seen during cross-clamping of the carotid vessels in 49 patients (mean ⌬TOIϭϪ9.4%, SDϭ7.1). Significant correlation was seen between TOI and flow velocity (rϭ0.56) but not with laser-Doppler flowmetry (rϭ0.13). In 31 patients, oxyhemoglobin and deoxyhemoglobin concentrations were recorded, showing significant changes during both external carotid artery and internal carotid artery clamping. A change in TOI was predominantly associated with internal carotid artery clamping (nϭ41). When TOI changed during external carotid artery clamping (nϭ8), significant blood pressure changes occurred, or extracranial-to-intracranial anastomosis was evident. In the absence of such variables, the sensitivity of TOI to intracranial and extracranial changes was 87.5% and 0%, respectively, and specificity was 100% and 0%, respectively. Conclusions-The NIRO 300 reflects changes in cerebral tissue oxygenation when TOI is calculated, with a high degree of sensitivity and specificity. (Stroke. 2001;32:2492-2500.)

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“…Lower or no correlation was found after changing paCO 2 and administration of mannitol. The high failure rate and the limited sensitivity affect the clinical use of near-infrared spectroscopy as a suitable part of neuromonitoring after acute brain injury at the present time (8).…”

Section: Discussionmentioning

confidence: 99%

Oximetry of the brain

Vilkė¹,

Macas²,

Bieliauskaitė³

et al. 2012

AML

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Background. Devices allowing direct assessment of brain tissue oxygenation have showed promising results in clinical studies. However, estimation of brain oximetry still has some challenges. The aim of our study was to estimate the feasibility to monitor cerebral oximetry for neurosurgery patients in the Operating Room and in the Neurosurgery Intensive Care Unit, possible basic disturbances for the study and early results. Materials and methods. The prospective trial took place in a tertiary university setting – the Neurosurgery Department of the Lithuanian University of Health Sciences Hospital (Kaunas Clinics). The monitoring was performed with an INVOS® Cerebral / Somatic Oximeter, which is based on near-infrared spectroscopy. The monitoring places were the Operating Room, later the Neurosurgery Intensive Care Unit and for some patients the regular Neurosurgery Ward. All patients had acute open or closed traumatic brain injury and had undergone neurosurgery. Results. 52 patients were included in the study, while 36 operations were performed after traumatic brain injury with successful monitoring. Preoperatively GCS ranged from 3 to 15 (average 10.2 ± 4.6), all patients had no hypotension ranged from 214 mmHg to 112 mmHg (average 148.0 ± 26.6), the mean arterial pressure ranged from 155 mmHg to 61 mmHg (average 106.0 ± 21.8), only two patients had hypoxia with SpO2 of 86% and 76%, other values averaged 96.7% ± 4.3% . Hemoglobin preoperatively ranged from 162 g/l to 82 g/l (average 133.7 ± 17.9). The va lues of cerebral oxygenation preoperatively in the Operating Room were 42–96% (average 74.8 ± 10.8), and one patient with cerebral oxy genation of 15% bilaterally before surgery died in 24 hours after the surgery (normal values vary from 58 to 82%). The values varied from to 15–95% in the period of the operation. The biggest difference of cerebral oxygenation between brain hemispheres was registered as 42% and 68% before the intubation, 60% (±8.8) and 76% (±4.0) during the operation, 64% (±4.9) and 80% (±5.3) in the Intensive Care Unit. 13 patients died, 17 were discharged with GCS of 13–15 and 6 patients with GCS of 8–12. Conclusions. Monitoring of regional cerebral oximetry for neurosurgery patients can be performed, despite of its limitations: surgery or application of the Mayfield holder in the frontal region of the head, intra operative transcranial Doppler monitoring

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Near-infrared spectroscopy - not useful to monitor cerebral oxygenation after severe brain injury

Cited by 45 publications

References 15 publications

Reliability of near-infrared spectroscopy measures of cerebral oxygenation and blood volume during handgrip exercise in nondisabled and traumatic brain-injured subjects

Reliability of near-infrared spectroscopy measures of cerebral oxygenation and blood volume during handgrip exercise in nondisabled and traumatic brain-injured subjects

Evaluation of a Near-Infrared Spectrometer (NIRO 300) for the Detection of Intracranial Oxygenation Changes in the Adult Head

Oximetry of the brain

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