Continuous Measurement of Cerebral Oxygenation with Near-Infrared Spectroscopy after Spontaneous Subarachnoid Hemorrhage

Abstract

Objective. The aim of our prospective study was to investigate the applicability and the diagnostic value of near-infrared spectroscopy (NIRS) in SAH patients using the cerebral oximeter INVOS 5100C. Methods. Measurement of cerebral oximetry was done continuously after spontaneous SAH. Decrease of regional oxygen saturation (rSO2) was analyzed and interpreted in view of the determined intrinsic and extrinsic factors. Changes of rSO2 values were matched with the values of ICP, tipO2, and TCD and the results of additional neuroimaging. Results. Continuous measurement of rSO2 was performed in nine patients with SAH (7 females and 2 males). Mean measurement time was 8.6 days (range 2–12 days). The clinical course was uneventful in 7 patients without occurrence of CVS. In these patients, NIRS measured constant and stable rSO2 values without relevant alterations. Special findings are demonstrated in 3 cases. Conclusion. Measurement of rSO2 with NIRS is a safe, easy to use, noninvasive additional measurement tool for cerebral oxygenation, which is used routinely during vascular and cardiac surgical procedures. NIRS is applicable over a long time period after SAH, especially in alert patients without invasive probes. Our observations were promising, whereby larger studies are needed to answer the open questions.

Mechanically switchable solid inhomogeneous phantom for performance tests in diffuse imaging and spectroscopy

“…Both chemical (related to absorption) and structural (related to scattering) information can be retrieved by photons traveling through the diffusive medium. Numerous applications have been pursued, both in the medical field-ranging from functional brain imaging 2,3 and neuromonitoring, [4][5][6] to cancer diagnostics 7,8 and therapy monitoring, 9,10 -and in industrial sectors such as characterization of food, 11,12 wood, 13,14 and pharmaceuticals. 15,16 A key requirement for such applications to grow and gain a more widespread clinical or industrial acceptance is to achieve a high grade of reliability, reproducibility, accuracy in quantification, and comparability of clinical results.…”

Transcranial regional cerebral oxygen desaturation predicts delayed cerebral ischaemia and poor outcomes after subarachnoid haemorrhage: A correlational study

“…They included nine patients with aSAH, seven of whom did not experience vasospasm. The authors reported a decline in rSO 2 that preceded new ischaemic stroke in one of the remaining patients (Maslehaty et al, 2012). Others have used NIRS during endovascular neuroradiologic procedures such as aneurysm and AVM embolisation and diagnostic angiography (Mazzeo et al, 2012).…”

The relationship between the time of cerebral desaturation episodes and outcome in aneurysmal subarachnoid haemorrhage: a preliminary study

“…Moreover, external factors such as cerebrospinal fluids or blood in the subarachnoid or subdural space may have an effect on the measurements [9,30]. Moreover, it has been shown that NIRS can monitor normal cerebral oxygenation values in patients with brain death [32,11,33]. It has been hypothesized that normal rSO2 during prolonged cardiac arrest may be the result of the absence of cerebral metabolism, preservation of the extracranial circulation (NIRS device is significantly influenced by the oxygenation of the scalp and skull), or a maintained residual cerebral perfusion.…”

“…As a non-invasive method, it could be applied at an early stage of brain damage and continuously used in subsequent days after the acute phase. NIRS consists in the emission of near-infrared light (NIR) and measures the absorbance of NIR by oxy-hemoglobine (oxy-HB) and deoxy-hemoglobine (deoxy-HB) according to the Beer-Lambert law [11]. NIRS is widely applied during cardiovascular or cardiopulmonary procedures to provide information about significant decreases in cerebral oxygenation in order to prevent neurological damage or cerebral injury [12].…”