Validation of a Second-Generation Near-Infrared Spectroscopy Monitor in Children With Congenital Heart Disease

Nasr, Viviane G.; Bergersen, Lisa; Lin, Hung‐Mo; Benni, Paul B.; Bernier, Rachel; Anderson, Michelle E.; Kussman, Barry D.

doi:10.1213/ane.0000000000002796

Cited by 15 publications

(11 citation statements)

References 37 publications

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“…The former includes venous blood from extracerebral tissue and may overestimate the actual cerebral venous saturation 24 , 45 . However, validation studies of NIRS devices predominantly use human jugular bulb oxygen saturation measurements 46 – 48 . We did not directly measure brain tissue oxygen tension; the oxygen dissociation curve is likely to be shifted at the tissue level by the acidotic brain pH and other local factors.…”

Section: Discussionmentioning

confidence: 99%

Excess cerebral oxygen delivery follows return of spontaneous circulation in near-term asphyxiated lambs

Badurdeen

Gill

Kluckow

et al. 2020

Sci Rep

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Hypoxic-ischaemia renders the neonatal brain susceptible to early secondary injury from oxidative stress and impaired autoregulation. We aimed to describe cerebral oxygen kinetics and haemodynamics immediately following return of spontaneous circulation (ROSC) and evaluate non-invasive parameters to facilitate bedside monitoring. Near-term sheep fetuses [139 ± 2 (SD) days gestation, n = 16] were instrumented to measure carotid artery (CA) flow, pressure, right brachial arterial and jugular venous saturation (SaO2 and SvO2, respectively). Cerebral oxygenation (crSO2) was measured using near-infrared spectroscopy (NIRS). Following induction of severe asphyxia, lambs received cardiopulmonary resuscitation using 100% oxygen until ROSC, with oxygen subsequently weaned according to saturation nomograms as per current guidelines. We found that oxygen consumption did not rise following ROSC, but oxygen delivery was markedly elevated until 15 min after ROSC. CrSO2 and heart rate each correlated with oxygen delivery. SaO2 remained > 90% and was less useful for identifying trends in oxygen delivery. CrSO2 correlated inversely with cerebral fractional oxygen extraction. In conclusion, ROSC from perinatal asphyxia is characterised by excess oxygen delivery that is driven by rapid increases in cerebrovascular pressure, flow, and oxygen saturation, and may be monitored non-invasively. Further work to describe and limit injury mediated by oxygen toxicity following ROSC is warranted.

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Section: Discussionmentioning

confidence: 99%

Excess cerebral oxygen delivery follows return of spontaneous circulation in near-term asphyxiated lambs

Badurdeen

Gill

Kluckow

et al. 2020

Sci Rep

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“…Near‐infrared spectroscopy (NIRS) for measurement of regional cerebral oxygenation was used to detect a possible decrease in cerebral perfusion. In a recent clinical study, an acceptable agreement with a weighted average from arterial und jugular bulb oxygenation saturation could be demonstrated 23 …”

Section: Discussionmentioning

confidence: 90%

Effect of etomidate on systemic and regional cerebral perfusion in neonates and infants with congenital heart disease: A prospective observational study

Dennhardt

Elfgen‐Schiffner

Keil

et al. 2020

Pediatric Anesthesia

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“…Previous studies have identified Deming regression analysis as a valid method to analyze the agreement between clinical monitoring methods, and it can be used to assess whether there is a fixed or proportional bias between the two monitoring methods ( Haji et al, 2015 ; Nasr et al, 2019 ). In this study, the Deming regression analysis was y = 5.6387 + 0.9067 x ( y is BIS, s is Ai), and the slope and intercept were both statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Consistency of the anesthesia consciousness index versus the bispectral index during laparoscopic gastrointestinal surgery with sevoflurane anesthesia: A prospective multi-center randomized controlled clinical study

Zhan

Chen²,

Wu³

et al. 2023

Front. Aging Neurosci.

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BackgroundThis study aimed to compare the consistency of anesthesia consciousness index (Ai) with that of bispectral index (BIS) in monitoring the depth of anesthesia (DOA) during sevoflurane anesthesia, to reveal the optimal cutoff values in different states of consciousness, and explore the stability of DOA monitoring during intraoperative injurious stimulation.MethodsWe enrolled 145 patients (97 men and 48 women) from 10 medical centers. General anesthesia was induced using intravenous anesthetics and maintained with sevoflurane. Ai and BIS values were recorded.ResultsThe mean difference between the Ai and BIS was-0.1747 (95% confidence interval, −0.6660 to 0.3166; p = 0.4857). The regression equation of Ai and BIS from the Deming regression analysis was y = 5.6387 + 0.9067x (y is BIS, x is Ai), and the slope and intercept were statistically significant. Meanwhile, the receiver operating characteristic curve analysis of anesthesia-induced unconsciousness, loss of consciousness, and recovery of consciousness revealed that the accuracy of Ai and BIS were similar. In addition, the optimal cutoff values of the different states of consciousness were not sensitive to age, and both Ai and BIS had no correlation with hemodynamics.ConclusionWe conclude that Ai and BIS show no systematic deviation in readings with high consistency, similar accuracy, and good stability; these insights provide more data for clinical application.

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Validation of a Second-Generation Near-Infrared Spectroscopy Monitor in Children With Congenital Heart Disease

Abstract: This study calibrated and validated the FORE-SIGHT Elite tissue oximeter to accurately measure SctO2 in pediatric patients with the medium sensor.

Cited by 15 publications

References 37 publications

Excess cerebral oxygen delivery follows return of spontaneous circulation in near-term asphyxiated lambs

Excess cerebral oxygen delivery follows return of spontaneous circulation in near-term asphyxiated lambs

Effect of etomidate on systemic and regional cerebral perfusion in neonates and infants with congenital heart disease: A prospective observational study

Consistency of the anesthesia consciousness index versus the bispectral index during laparoscopic gastrointestinal surgery with sevoflurane anesthesia: A prospective multi-center randomized controlled clinical study

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