Survey of the Clinical Assessment and Utility of Near-Infrared Cerebral Oximetry in Cardiac Surgery

Zacharias, David G.; Lilly, Kevin J.; Shaw, Cynthia L.; Pirundini, Paul A.; Rizzo, Robert J.; Body, Simon C.; Longford, Nicholas T.

doi:10.1053/j.jvca.2013.06.003

Cited by 31 publications

(23 citation statements)

References 40 publications

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“…15 Although overall performance of cerebral oximeters has improved significantly since they were first introduced, a recent study that compared 5 commercially available brain oximeters found significant accuracy variability between and within these devices, indicating a need for further improvements of the technology. 16 …”

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confidence: 99%

Absolute and Trend Accuracy of a New Regional Oximeter in Healthy Volunteers During Controlled Hypoxia

Redford

Paidy

Kashif

2014

Anesthesia &Amp; Analgesia

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BACKGROUND:Traditional patient monitoring may not detect cerebral tissue hypoxia, and typical interventions may not improve tissue oxygenation. Therefore, monitoring cerebral tissue oxygen status with regional oximetry is being increasingly used by anesthesiologists and perfusionists during surgery. In this study, we evaluated absolute and trend accuracy of a new regional oximetry technology in healthy volunteers.METHODS:A near-infrared spectroscopy sensor connected to a regional oximetry system (O3TM, Masimo, Irvine, CA) was placed on the subject’s forehead, to provide continuous measurement of regional oxygen saturation (rSo2). Reference blood samples were taken from the radial artery and internal jugular bulb vein, at baseline and after a series of increasingly hypoxic states induced by altering the inspired oxygen concentration while maintaining normocapnic arterial carbon dioxide pressure (Paco2). Absolute and trend accuracy of the regional oximetry system was determined by comparing rSo2 against reference cerebral oxygen saturation (Savo2), that is calculated by combining arterial and venous saturations of oxygen in the blood samples.RESULTS:Twenty-seven subjects were enrolled. Bias (test method mean error), standard deviation of error, standard error of the mean, and root mean square accuracy (ARMS) of rSo2 compared to Savo2 were 0.4%, 4.0%, 0.3%, and 4.0%, respectively. The limits of agreement were 8.4% (95% confidence interval, 7.6%–9.3%) to −7.6% (95% confidence interval, −8.4% to −6.7%). Trend accuracy analysis yielded a relative mean error of 0%, with a standard deviation of 2.1%, a standard error of 0.1%, and an ARMS of 2.1%. Multiple regression analysis showed that age and skin color did not affect the bias (all P > 0.1).CONCLUSIONS:Masimo O3 regional oximetry provided absolute root-mean-squared error of 4% and relative root-mean-squared error of 2.1% in healthy volunteers undergoing controlled hypoxia.

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confidence: 99%

Absolute and Trend Accuracy of a New Regional Oximeter in Healthy Volunteers During Controlled Hypoxia

Redford

Paidy

Kashif

2014

Anesthesia &Amp; Analgesia

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“…Owing to the advantage of simple, continuous, and noninvasive monitoring, NIRS has the potential to become a valuable tool to optimize patient care in our daily anesthesia practice. Following that, it is always useful to remember that no monitoring device -no matter how insightful its data are -will improve patient outcome unless used with a comprehensive monitoring strategy [57].…”

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confidence: 99%

Cerebral oximetry

Moerman

Hert

2015

Current Opinion in Anaesthesiology

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“…The use of this technology is variable and there is evidence of equipoise with regard to its effectiveness. 211 To address this uncertainty we undertook a multicentre RCT to assess the clinical utility and cost-effectiveness of patient-specific goal-directed NIRS-based algorithms in cardiac surgery. We also undertook a systematic review and meta-analysis of the available evidence from RCTs that have assessed the clinical utility of this technology, to identify knowledge gaps in the existing evidence and provide recommendations for further research.…”

Section: What Knowledge Gap Is Being Addressed By This Studymentioning

confidence: 99%

“…However, previous trials have reported benefits from the use of NIRS-based algorithms. 235 To reconcile these disparate findings, and to address equipoise with regard to effectiveness and variations in use, 211 we undertook a systematic review and meta-analysis of the available evidence from RCTs to assess the clinical utility of this technology, identify knowledge gaps in the existing evidence and provide recommendations for further research. The review protocol was registered (PROSPERO CRD42015027696) and the review is reported in accordance with the PRISMA statement 131 (see Appendix 1).…”

Section: Overviewmentioning

confidence: 99%

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Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials

Murphy

Mumford

Rogers

et al. 2017

Programme Grants Appl Res

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This report should be referenced as follows:Murphy GJ, Mumford AD, Rogers CA, Wordsworth S, Stokes EA, Verheyden V, et al. Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials. Programme Grants Appl Res 2017;5(17). Programme Grants for Applied ResearchISSN 2050-4322 (Print) ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: journals.library@nihr.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10384. The contractual start date was in July 2008. The final report began editorial review in July 2016 and was accepted for publication in April 2017. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not ...

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Survey of the Clinical Assessment and Utility of Near-Infrared Cerebral Oximetry in Cardiac Surgery

Cited by 31 publications

References 40 publications

Absolute and Trend Accuracy of a New Regional Oximeter in Healthy Volunteers During Controlled Hypoxia

Absolute and Trend Accuracy of a New Regional Oximeter in Healthy Volunteers During Controlled Hypoxia

Cerebral oximetry

Diagnostic and therapeutic medical devices for safer blood management in cardiac surgery: systematic reviews, observational studies and randomised controlled trials

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