Assessing changes in tissue oxygenation by near-infrared spectroscopy following brachial plexus block for arteriovenous fistula surgery

Keuler, Jonas; Weiß, Carsten; Klemm, Klaus; Pochhammer, Julius; Schmidt, René; Ilies, C.

doi:10.1097/eja.0000000000000871

Cited by 9 publications

(8 citation statements)

References 38 publications

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“…Currently, there are no data on rSO 2 changes after a CCBPB or data comparing the effect of different BPB techniques on rSO 2 but our results are comparable with that reported by Keuler et al 3 after a supraclavicular BPB. As blood flow, oxygen delivery (DO 2 ) and rSO 2 show a strong correlation, 4 we believe the increase in rSO 2 that we have demonstrated at the thenar eminence after the CCBPB is because of an increase in blood flow 1 because of the ipsilateral vasodilation of the upper extremity vessels, 1 and thus, the DO 2 , to the upper extremity.…”

supporting

confidence: 90%

Regional tissue oxygen saturation after costoclavicular brachial plexus block

Areeruk

Sivakumar

Somani

et al. 2022

European Journal of Anaesthesiology

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supporting

confidence: 90%

Regional tissue oxygen saturation after costoclavicular brachial plexus block

Areeruk

Sivakumar

Somani

et al. 2022

European Journal of Anaesthesiology

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“…Prior reports have validated NIRS to reflect peripheral perfusion during acute compartment syndrome ( 24 ), extracorporeal membrane oxygenation ( 25 , 26 ), free flap reconstruction ( 27 ), and regional anesthesia ( 28 ). Although research into use of NIRS has examined end points of resuscitation and prognostication tools, which is important for the translation from bench to bedside, there has been less work in the area of fluid responsiveness.…”

Section: Discussionmentioning

confidence: 99%

Near-Infrared Spectroscopy for Determination of Cardiac Output Augmentation in a Swine Model of Ischemia-Reperfusion Injury

Patel

Templeton

Lane

et al. 2022

Critical Care Explorations

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Near infrared spectroscopy (NIRS) is a noninvasive tool for assessing local oxygen balance. In circulatory shock, the microcirculatory environment as measured by NIRS during resuscitation may provide additional diagnostic tools of value to the critical care physician. HYPOTHESIS:To assess whether a relative increase in peripheral NIRS was correlated with a clinically relevant increase in cardiac output following a fluid bolus in a swine model of shock. METHODS AND MODELS:Nine healthy young adult swine with median weight 80 kg (interquartile range, 75-83 kg) were anesthetized and surgically instrumented. They underwent a controlled hemorrhage of 20% of their blood volume followed by partial or complete aortic occlusion to create a variable ischemiareperfusion injury. Next, the animals underwent four 500-mL plasmalyte boluses over 9 minutes each followed by a 6-minute pause. The animal then underwent a 25% mixed auto/homologous blood transfusion followed by four more 500 mL plasmalyte boluses over 9 minutes. Finally, the animals underwent a 25% mixed auto/homologous blood transfusion followed by an additional four rounds of 500-mL plasmalyte boluses over 9 minutes. Left thoracic limb NIRS, descending thoracic aortic flow (dAF), arterial blood pressure (MAP), central venous pressure (CVP), and mixed central venous oxygen saturation (Svo 2 ) were measured continuously for comparison. RESULTS:The area under the receiver operating curve for an increase in dAF of 10% in response to a 500 mL bolus based on a percent increase in the proximal NIRS was 0.82 with 95% CI, 0.72-0.91; Svo 2 , 0.86 with 95% CI, 0.78-0.95; MAP, 0.75 with 95% CI, 0.65-0.85 and CVP, 0.64 with 95% CI, 0.53-0.76. INTERPRETATION AND CONCLUSIONS:A dynamic relative increase in NIRS in response to a crystalloid challenge has moderate discriminatory power for cardiac output augmentation during shock in a swine model of ischemiareperfusion injury. NIRS performed as well as invasive measurements (Svo 2 and MAP) and better than CVP. N ear-infrared spectroscopy (NIRS) is a noninvasive tool that uses 600-1,000 nanometer light waves to penetrate superficial tissues and the differential refraction of the oxygenated and deoxygenated hemoglobin to calculate a percentage of oxygenated blood (1). The premise of NIRS is intriguing as a tool to measure the microcirculation, as this is the level at which oxygen is used and is hypothesized to be dysfunctional during states of shock. Therefore, the quantification of the microcirculation as provided by NIRS might provide a tool for the critical care physician to guide resuscitation in shock.Research surrounding NIRS has been substantial, gaining interest initially as a noninvasive technique for monitoring cerebral perfusion during cardiac

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“…Unlike LA infiltration, RA blocks not only motor and sensory nerves but also sympathetic nerves, resulting in vasodilatation, reduced vasospasm and increased blood flow through the new AVF. 17,18 Whilst GA also results in intra-operative vasodilatation, such potentially beneficial vasodilation will not persist beyond emergence to the extent associated with RA. Furthermore, the comorbidities associated with, and resulting from, ESRD increase the risk of perioperative complications secondary to GA in this group of patients.…”

Section: Determinants Of Fistula Maturationmentioning

confidence: 99%