Near-Infrared Spectroscopy Monitoring of Cerebral Oxygenation and Influencing Factors in Neonates from High-Altitude Areas

Neonatology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Bi Ze ◽  
Lili Liu ◽  
Ge Sang Yang Jin ◽  
Minna Shan ◽  
Yuehang Geng ◽  
...  
Keyword(s):  
Heart Disease ◽  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Oxygen Saturation ◽  
High Altitude ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Low Altitude ◽  
Normal Neonates

<b><i>Background:</i></b> Accurate detection of cerebral oxygen saturation (rSO<sub>2</sub>) may be useful for neonatal brain injury prevention, and the normal range of rSO<sub>2</sub> of neonates at high altitude remained unclear. <b><i>Objective:</i></b> To compare cerebral rSO<sub>2</sub> and cerebral fractional tissue oxygen extraction (cFTOE) at high-altitude and low-altitude areas in healthy neonates and neonates with underlying diseases. <b><i>Methods:</i></b> 515 neonates from low-altitude areas and 151 from Tibet were enrolled. These neonates were assigned into the normal group, hypoxic-ischemic encephalopathy (HIE) group, and other diseases group. Near-infrared spectroscopy was used to measure rSO<sub>2</sub> in neonates within 24 h after admission. The differences of rSO<sub>2</sub>, pulse oxygen saturation (SpO<sub>2</sub>), and cFTOE levels were compared between neonates from low- and high-altitude areas. <b><i>Results:</i></b> (1) The mean rSO<sub>2</sub> and cFTOE levels in normal neonates from Tibet were 55.0 ± 6.4% and 32.6 ± 8.5%, significantly lower than those from low-altitude areas (<i>p</i> &#x3c; 0.05). (2) At high altitude, neonates with HIE, pneumonia (<i>p</i> &#x3c; 0.05), anemia, and congenital heart disease (<i>p</i> &#x3c; 0.05) have higher cFTOE than healthy neonates. (3) Compared with HIE neonates from plain areas, neonates with HIE at higher altitude had lower cFTOE (<i>p</i> &#x3c; 0.05), while neonates with heart disease in plateau areas had higher cFTOE than those in plain areas (<i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> The rSO<sub>2</sub> and cFTOE levels in normal neonates from high-altitude areas are lower than neonates from the low-altitude areas. Lower cFTOE is possibly because of an increase in blood flow to the brain, and this may be adversely affected by disease states which may increase the risk of brain injury.

Accuracy of a Cerebral Oximeter in Healthy Volunteers under Conditions of Isocapnic Hypoxia 

1998 ◽  
Vol 88 (1) ◽  
pp. 58-65 ◽  
Author(s):  
Lindsey C. Henson ◽  
Carolyn Calalang ◽  
John A. Temp ◽  
Denham S. Ward
Keyword(s):  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Healthy Volunteers ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Jugular Bulb ◽  
Wide Range ◽  
Cerebral Oximeter ◽  
End Tidal

Background A cerebral oximeter measures oxygen saturation of brain tissue noninvasively by near infrared spectroscopy. The accuracy of a commercially available oximeter was tested in healthy volunteers by precisely controlling end-tidal oxygen (P[ET]O2) and carbon dioxide (P[ET]CO2) tensions to alter global cerebral oxygen saturation. Methods In 30 healthy volunteers, dynamic end-tidal forcing was used to produce step changes in P[ET]O2 resulting in arterial saturation ranging from approximately 70% to 100% under conditions of controlled normocapnia (each person's resting P[ET]CO2) or hypercapnia (resting plus 7-10 mmHg). Blood arterial (SaO2) and jugular bulb venous (S[jv]O2) saturations during each P(ET)O2 interval were determined by co-oximetry. The cerebral oximeter reading (rSO2) and an estimated jugular venous saturation (S[jv]O2), derived from a combination of SaO2 and rSO2, were compared with the measured S(jv)O2. Results The S(jv)O2 was significantly higher with hypercapnia than with normocapnia for the same SaO2. The rSO2 and S(jv)O2 were both highly correlated with S(jv)O2 for individual volunteers (mean r2 = 0.91 for each relation); however, the slopes and intercepts varied widely among volunteers. In three of them, the cerebral oximeter substantially underestimated the measured S(jv)O2. Conclusions During isocapnic hypoxia in healthy persons, cerebral oxygenation as estimated by near infrared spectroscopy precisely tracks changes in measured S(jv)O2 within individuals, but the relation exhibits a wide range of slopes and intercepts. Therefore the clinical utility of the device is limited to situations in which tracking trends in cerebral oxygenation would be acceptable.

scholarly journals Changes in cerebral oxygen saturation and cerebral blood flow velocity under mild +Gz hypergravity

2019 ◽  
Vol 127 (1) ◽  
pp. 190-197 ◽  
Author(s):  
Toru Konishi ◽  
Takuya Kurazumi ◽  
Tomokazu Kato ◽  
Chiharu Takko ◽  
Yojiro Ogawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Infrared Spectroscopy ◽  
Oxygen Saturation ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Cerebral Oxygen Saturation ◽  
Cerebral Oxygen ◽  
Regional Cerebral Oxygen Saturation

We previously reported that cerebral blood flow (CBF) was reduced by even mild +Gz hypergravity. Regional cerebral oxygen saturation as measured by near-infrared spectroscopy (C-rSO2) has been widely used to detect cerebral ischemia in clinical practice. For example, decreases in C-rSO2reflect reduced CBF or arterial oxygen saturation. Thus it was hypothesized that C-rSO2would decrease in association with reduced CBF during mild hypergravity. To test this hypothesis, we measured CBF velocity by transcranial Doppler ultrasonography and C-rSO2during mild +Gz hypergravity while participants were in a sitting position. Among 17 male participants, 15 completed 21 min of exposure to +1.5 Gz generated by short-arm centrifuge. C-rSO2and mean CBF velocity in the middle cerebral artery (MCBFVMCA) during centrifugation were averaged every 5 min and compared with pre-hypergravity (+1.0 Gz). C-rSO2did not change significantly throughout centrifugation, although MCBFVMCAgradually decreased from the beginning (−1.2% at 0–5 min), and significantly decreased at 5–10 min (−4.8%), 10–15 min (−6.7%), and 15–20 min (−7.4%). Contrary to our hypothesis, decreases in C-rSO2were not detected, despite reductions in CBF velocity during hypergravity. Since some assumptions, such as unaltered arteriovenous volume ratio, hemoglobin concentration, extracranial blood flow, and brain activity, need to be satisfied to monitor cerebral ischemia by C-rSO2, the present results suggest that these necessary assumptions for near-infrared spectroscopy are not always applicable, and that cerebral oxygenation may not precisely reflect decreases in CBF under mild +Gz hypergravity.NEW & NOTEWORTHY To our knowledge, this is the first study to evaluate simultaneously cerebral oxygenation monitored by near-infrared spectroscopy and cerebral blood flow (CBF) monitored by transcranial Doppler under +1.5 Gz hypergravity. Contrary to our hypothesis, there was no significant correlation between CBF velocity and regional cerebral oxygen saturation (C-rSO2). However, an incomplete case nearly involving syncope suggests the possibility that C-rSO2can detect a remarkable decrease in CBF with development of presyncope during +Gz hypergravity.

scholarly journals Near-infrared spectroscopy in the assessment of cerebral oxygenation at high altitude

1998 ◽  
Vol 9 (4) ◽  
pp. 198-203 ◽  
Author(s):  
C.H.E. Imray ◽  
N.J. Barnett ◽  
S. Walsh ◽  
T. Clarke ◽  
J. Morgan ◽  
...  
Keyword(s):  
Infrared Spectroscopy ◽  
High Altitude ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation

Cerebral Monitoring by Near-Infrared Spectroscopy

1996 ◽  
Vol 11 (3) ◽  
pp. 162-172 ◽  
Author(s):  
Miles Tsuji
Keyword(s):  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Optical Monitoring ◽  
Volume Changes ◽  
Hemoglobin Oxygenation ◽  
Monitoring Technologies ◽  
Cerebral Monitoring

Near-infrared spectroscopy (NIRS) is a noninvasive optical monitoring technology that can provide information on relative cerebral oxyhemoglobin, deoxyhemoglobin, and oxidized cytochrome aa3 concentrations. Unlike other bedside clinical monitoring technologies, NIRS provides direct information on cerebral hemoglobin oxygenation and blood volume changes. NIRS recordings have documented changes in cerebral oxygenation in fetuses during labor, critically ill premature infants, cardiopulmonary bypass patients, and adult surgical patients. This information may improve understanding of the causes of brain injury and allow detection of inadequate oxygen delivery before brain injury occurs. Future developments in NIRS technology are likely to produce practical, quantitative bedside monitors of global and regional cerebral oxygenation.

scholarly journals Near-Infrared Spectroscopy (NIRS) in Traumatic Brain Injury (TBI)

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1586
Author(s):  
María Roldán ◽  
Panayiotis A. Kyriacou
Keyword(s):  
Traumatic Brain Injury ◽  
Infrared Spectroscopy ◽  
Brain Injury ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Cerebral Oxygenation ◽  
Noninvasive Monitoring ◽  
Infrared Light ◽  
Cochrane Library ◽  
The Brain

Traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain. TBI can result when the head suddenly and violently impacts an object or when an object pierces the skull and enters brain tissue. Secondary injuries after traumatic brain injury (TBI) can lead to impairments on cerebral oxygenation and autoregulation. Considering that secondary brain injuries often take place within the first hours after the trauma, noninvasive monitoring might be helpful in providing early information on the brain’s condition. Near-infrared spectroscopy (NIRS) is an emerging noninvasive monitoring modality based on chromophore absorption of infrared light with the capability of monitoring perfusion of the brain. This review investigates the main applications of NIRS in TBI monitoring and presents a thorough revision of those applications on oxygenation and autoregulation monitoring. Databases such as PubMed, EMBASE, Web of Science, Scopus, and Cochrane library were utilized in identifying 72 publications spanning between 1977 and 2020 which were directly relevant to this review. The majority of the evidence found used NIRS for diagnosis applications, especially in oxygenation and autoregulation monitoring (59%). It was not surprising that nearly all the patients were male adults with severe trauma who were monitored mostly with continue wave NIRS or spatially resolved spectroscopy NIRS and an invasive monitoring device. In general, a high proportion of the assessed papers have concluded that NIRS could be a potential noninvasive technique for assessing TBI, despite the various methodological and technological limitations of NIRS.

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