Quantifying cerebral hypoxia by near-infrared spectroscopy tissue oximetry: the role of arterial-to-venous blood volume ratio

Rasmussen, Martin Bo; Eriksen, Vibeke R.; Andresen, Björn F.; Hyttel-Sørensen, Simon; Greisen, Gorm

doi:10.1117/1.jbo.22.2.025001

Cited by 11 publications

(9 citation statements)

References 37 publications

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“…During hypoxia, the decline of rcSO 2 reflects a concurrent decrease in arterial oxy-haemoglobin saturation and a rise in venous deoxy-hemoglobin saturation (10). In addition, Rasmussen et al (19) indicated that cerebral NIRS oximetry responded poorly to changes in tissue oxygenation during hypotension that was induced by decreased preloading. This may be due to the increase in the artery-to-vein ratio that occurs following the decrease in oxygen delivery, which is due to arterial vasodilation and possibly cerebral venous collapse.…”

Section: Discussionmentioning

confidence: 99%

Comparing the response of pulse oximetry and regional cerebral oxygen saturation to hypoxia in preschool children

et al. 2019

Exp Ther Med

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Pulse oximetry and measurement of regional cerebral oxygen saturation (rcSO 2) are used to monitor peripheral and cerebral oxygenation, respectively. However, the response of rcSO 2 and pulse oxygen saturation (SpO 2) to hypoxia in preschool children has not been previously assessed. A total of 36 preschool patients who had undergone a tonsillectomy [age, 4-6 years, American Society of Anesthesiologists grade I or II] were screened and prospectively enrolled in the present study. Hemodynamics, including rcSO 2 , SpO 2 , non-invasive blood pressure, heart rate, electrocardiogram and capnography, were continuously monitored throughout the study. Following pre-oxygenation, pressure-controlled ventilation with 100% oxygen was administered through a mask with a flow rate of 6 l/min, under total intravenous anesthesia, and the end-tidal carbon dioxide partial pressure was maintained between 30 and 40 mmHg. Tracheal intubation was then performed and ventilation was paused until SpO 2 decreased to 90% or rcSO 2 decreased by >10% of the baseline level. The duration from pausing of mechanical ventilation to the start of the rcSO 2 decline was shorter than that of SpO 2 (80.2±23.6 sec vs. 124.4±20.5 sec; P<0.001). Subsequent to the recovery of ventilation, the duration from the starting point to the increasing point of the baseline of rcSO 2 was longer than that of SpO 2 (84.8±24.3 sec vs. 15.2±6.8 sec; P<0.001). From the point where mechanical ventilation was paused to when rcSO 2 /SpO 2 began to decrease, the rcSO 2 and SpO 2 values decreased and a significant correlation of them was observed (Pearson's correlation coefficient=0.317; P=0.027). From the time-point where mechanical ventilation was recovered to the time-point where rcSO 2 or SpO 2 began to increase, rcSO 2 and SpO 2 values decreased and a significant correlation of them was observed (Spearman's correlation coefficient= 0.489; P= 0.006). From the baseline to the minimum value, compared with the SpO 2 , the rcSO 2 declined at a decreased rate (9.7±0.5% vs. 5.3±2.7%; P<0.001). The present clinical trial was registered at http://www.chictr.org.cn on 14th March 2016 (registration no. ChiCTR-OOC-16008095).

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Section: Discussionmentioning

confidence: 99%

Comparing the response of pulse oximetry and regional cerebral oxygen saturation to hypoxia in preschool children

et al. 2019

Exp Ther Med

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“…The ratio differs according to the device, and the assumed ratio is 25:75 for the INVOS ® and 30:70 for the FORE-SIGHT ® , EQUANOX ® , and NIRO ® [17]. A previous study showed that blood pressure could affect cerebral oximetry values according to the A/V ratio [18]. O3 TM can change its preset A/V ratio between 25:75 and 30:70; therefore, it would be a useful device with an adjustable setting based on the clinical situation or blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Different Near-Infrared Spectroscopy Devices for Assessing Tissue Oxygenation with a Vascular Occlusion Test in Healthy Volunteers

Chung

Jang

et al. 2020

J Vasc Res

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Near-infrared spectroscopy devices can measure peripheral tissue oxygen saturation (StO 2). This study aims to compare StO 2 using INVOS ® and different O3™ settings (O3 25:75 and O3 30:70). Twenty adults were recruited. INVOS ® and O3™ probes were placed simultaneously on 1 side of forearm. After baseline measurement, the vascular occlusion test was initiated. The baseline value, rate of deoxygenation and reoxygenation, minimum and peak StO 2 , and time from cuff release to peak value were measured. The parameters were compared using ANOVA and Kruskal-Wallis tests. Bonferroni's correction and Mann-Whitney pairwise comparison were used for post hoc analysis. The agreement between StO 2 of devices was evaluated using Bland-Altman plots. IN-VOS ® baseline value was higher (79.7 ± 6.4%) than that of O3 25:75 and O3 30:70 (62.4 ± 6.0% and 63.7 ± 5.5%, respectively, p < 0.001). The deoxygenation rate was higher with IN-VOS ® (10.6 ± 2.1%/min) than with O3 25:75 and O3 30:70 (8.4 ± 2.2%/min, p = 0.006 and 7.5 ± 2.1%/min, p < 0.001). The minimum and peak StO 2 were higher with INVOS ®. No significant difference in the reoxygenation rate was found between the devices and settings. The time to reach peak after cuff deflation was faster with INVOS ® (both p < 0.001). Other parameters were similar. There were no differences between the different O3™ settings. There were differences in StO 2 measurements between the devices, and these devices should not be interchanged. Differences were not observed between O3™ device settings.

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“…If FIRS resulted in a centralization of the circulation, this may have changed the ratio of the arterial, capillary and venous compartments. As a consequence this resulted in a local decrease of oxygen consumption, because of a higher proportion of arterial blood vessels (relative to reduced number of capillary vessels within the measurement compartments), resulting in higher values of crSO2 and consecutively in lower cFTOE values ( 27 , 28 ). However, we do not have detailed information about the behavior of cerebral blood flow to define exact changes in cerebral perfusion to prove the underlying mechanism of the observed differences between groups ( 13 , 14 , 29 ).…”

Section: Discussionmentioning

confidence: 99%

Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates

et al. 2020

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Introduction: Fetal inflammatory response syndrome (FIRS), defined as elevated umbilical cord blood interleukin-6 (IL-6) values > 11 pg/ml, is associated with an increased risk of neonatal morbidity and mortality. The primary aim of the present study was to evaluate a potential influence of FIRS on cerebral oxygen saturation (crSO2) and fractional tissue oxygen extraction (cFTOE) during immediate postnatal transition in preterm neonates. The secondary aim was to analyze the potential influence of FIRS on cerebral injury and mortality. Methods: Secondary outcome parameters of prospective observational studies were analyzed. Preterm neonates with measured IL-6 values from umbilical cord blood and cerebral near-infrared spectroscopy (NIRS) measurements during immediate transition after birth were included. Preterm neonates with FIRS (FIRS group) were matched 1:1 for gestational age (± 1 week) to preterm neonates without FIRS (non-FIRS group). crSO2, cFTOE, arterial oxygen saturation (SpO2), heart rate (HR), and fraction of inspired oxygen (FiO2) were compared between both groups. In addition, cerebral injury and mortality were compared between both groups. Results: A total of 46 preterm neonates were included. Twenty-three neonates in the FIRS group [median gestational age 32.1 (IQR 30.3–33.0) weeks; median IL-6 19.7 (IQR 12.2–37.0) pg/ml] were compared to 23 neonates in the non-FIRS group [gestational age: 32.0 (30.4–33.1) weeks; IL-6: 5.4 (3.0–6.7) pg/ml]. cFTOE showed significantly lower values within the first 4 min and a trend toward lower values in minute 5 after birth in the FIRS group. There were no significant differences in crSO2 within the first 15 min after birth between the two groups. SpO2 was significantly lower in minutes 5 and 6 and HR was significantly lower in minutes 2 and 4 after birth in the FIRS group compared to the non-FIRS group. Survival without cerebral injury was similar in both groups. Conclusion: In preterm neonates with FIRS the crSO2 was similar despite significantly lower cFTOE values during the first minutes after birth. This observation may be a result of compromised oxygen consumption and delivery in the first minutes after birth in neonates with FIRS.

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Quantifying cerebral hypoxia by near-infrared spectroscopy tissue oximetry: the role of arterial-to-venous blood volume ratio

Cited by 11 publications

References 37 publications

Comparing the response of pulse oximetry and regional cerebral oxygen saturation to hypoxia in preschool children

Comparing the response of pulse oximetry and regional cerebral oxygen saturation to hypoxia in preschool children

Evaluation of Different Near-Infrared Spectroscopy Devices for Assessing Tissue Oxygenation with a Vascular Occlusion Test in Healthy Volunteers

Fetal Inflammatory Response Syndrome and Cerebral Oxygenation During Immediate Postnatal Transition in Preterm Neonates

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