Cerebral and somatic venous oximetry in adults and infants

Booth, Erin A.; Dukatz, Chris; Ausman, James I.; Wider, Michael D.

doi:10.4103/2152-7806.73316

Cited by 42 publications

(39 citation statements)

References 45 publications

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“…More recent advances in modeling and instrumentation have led to the development of quantitative spectroscopic probes capable of measuring total tissue oxygenation (arterial & venous). [4][5][6][7][8][9] However, these devices typically provide local measurements and require a priori knowledge of the location of a potential oxygenation defect. Thus, an imaging system that offers truly passive monitoring by measuring large areas of tissue oxygenation without a priori knowledge would aid patient management in many surgical and critical care applications.…”

Section: Introductionmentioning

confidence: 99%

First-in-human pilot study of a spatial frequency domain oxygenation imaging system

et al. 2011

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Abstract. Oxygenation measurements are widely used in patient care. However, most clinically available instruments currently consist of contact probes that only provide global monitoring of the patient (e.g., pulse oximetry probes) or local monitoring of small areas (e.g., spectroscopy-based probes). Visualization of oxygenation over large areas of tissue, without a priori knowledge of the location of defects, has the potential to improve patient management in many surgical and critical care applications. In this study, we present a clinically compatible multispectral spatial frequency domain imaging (SFDI) system optimized for surgical oxygenation imaging. This system was used to image tissue oxygenation over a large area (16×12 cm) and was validated during preclinical studies by comparing results obtained with an FDA-approved clinical oxygenation probe. Skin flap, bowel, and liver vascular occlusion experiments were performed on Yorkshire pigs and demonstrated that over the course of the experiment, relative changes in oxygen saturation measured using SFDI had an accuracy within 10% of those made using the FDA-approved device. Finally, the new SFDI system was translated to the clinic in a firstin-human pilot study that imaged skin flap oxygenation during reconstructive breast surgery. Overall, this study lays the foundation for clinical translation of endogenous contrast imaging using SFDI. C 2011 Society of Photo-Optical Instrumentation Engineers (SPIE).

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Section: Introductionmentioning

confidence: 99%

First-in-human pilot study of a spatial frequency domain oxygenation imaging system

et al. 2011

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“…Adequate cerebral oxygenation helps sustain good cerebral function [35] and is also a good indicator of adequate systemic oxygenation [38]. Renal near infra-red spectroscopy (NIRS) has been used extensively in paediatric surgery [39] but has found limited applicability for adult monitoring, thought to be due to a limited depth of tissue penetration by NIR photons.…”

Section: Impaired Tissue Blood Flow Regulationmentioning

confidence: 99%

Clarification of the circulatory patho-physiology of anaesthesia – Implications for high-risk surgical patients

Wolff

Green

2014

International Journal of Surgery

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The paper examines the effects of anaesthesia on circulatory physiology and their implications regarding improvement in perioperative anaesthetic management. Changes to current anaesthetic practice, recommended recently, such as the use of flow monitoring in high risk patients, are already beginning to have an impact in reducing complications but not mortality [1]. Better understanding of the patho-physiology should help improve management even further. Analysis of selected individual clinical trials has been used to illustrate particular areas of patho-physiology and how changes in practice have improved outcome. There is physiological support for the importance of achieving an appropriate rate of oxygen delivery (DO2), particularly following induction of anaesthesia. It is suggested that ensuring adequate DO2 during anaesthesia will avoid development of oxygen debt and hence obviate the need to induce a high, compensatory, DO2 in the post-operative period. In contrast to the usual assumptions underlying strategies requiring a global increase in blood flow [1] by a stroke volume near maximization strategy, blood flow control actually resides entirely at the tissues not at the heart. This is important as the starting point for understanding failed circulatory control as indicated by 'volume dependency'. Local adjustments in blood flow at each individual organ - auto-regulation - normally ensure the appropriate local rate of oxygen supply, i.e. local DO2. Inadequate blood volume leads to impairment of the regulation of blood flow, particularly in the individual tissues with least capable auto-regulatory capability. As demonstrated by many studies, inadequate blood flow first occurs in the gut, brain and kidney. The inadequate blood volume which occurs with induction of anaesthesia is not due to blood volume loss, but probably results from redistribution due to veno-dilation. The increase in venous capacity renders the existing blood volume inadequate to maintain venous return and pre-load. Blood volume shifted to the veins will, necessarily, also reduce the arterial volume. As a result stroke volume and cardiac output fall below normal with little or no change in peripheral resistance. The resulting pre-load dependency is often successfully treated with colloid infusion and, in some studies, 'inotropic' agents, particularly in the immediate post-operative phase. Treatment during the earliest stage of anaesthesia can avoid the build up of oxygen debt and may be supplemented by drugs which maintain or restore venous tone, such as phenylephrine; an alternative to volume expansion. Interpretation of circulatory patho-physiology during anaesthesia confirms the need to sustain appropriate oxygen delivery. It also supports reduction or even elimination of supplementary crystalloid maintenance infusion, supposedly to replace the "mythical" third space loss. As a rational evidence base for future research it should allow for further improvements in anaesthetic management.

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“…Многочисленные исследователи продемонстрировали, что применение ЦО приводит к снижению длительности гос питализации на 1,7-2,7 дней, уменьшению на 11% затрат на лечение, общему регрессу неврологических осложнений до 85%, сокращению периоперативного инсульта с 2,01% до 0,97%, по другим данным -в 4-5 раз, в том числе, и у пациен тов с диабетом [11,21,33,55].…”

Section: факторы риска развития но при кардиохирургических операцияхunclassified

“…При использовании ЦО только в 2% случаев у пациентов воз никали осложнения, входящие в модель риска RОММ, в отли чие от 10% случаев без использования ЦО [11,33,55].…”

Section: факторы риска развития но при кардиохирургических операцияхunclassified

Cerebral Oximetry in Cardiac Surgery

Шепелюк¹,

Клыпа²,

Никифоров³

2012

rmt

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Cerebral and somatic venous oximetry in adults and infants

Cited by 42 publications

References 45 publications

First-in-human pilot study of a spatial frequency domain oxygenation imaging system

First-in-human pilot study of a spatial frequency domain oxygenation imaging system

Clarification of the circulatory patho-physiology of anaesthesia – Implications for high-risk surgical patients

Cerebral Oximetry in Cardiac Surgery

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