Continuous noninvasive measurement of cerebral arterial and venous oxygen saturation at the bedside in mechanically ventilated neonates

Wolf, Martin; Duc, Gabriel; Keel, M.; Niederer, Peter F.; Siebenthal, Kurt von; Bucher, Hans Ulrich

doi:10.1097/00003246-199709000-00028

Cited by 49 publications

(44 citation statements)

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“…2) The vo method can be applied only to limbs, whereas the resp method can, in principle, be applied to any tissue and in particular to the brain, as already shown by Wolf et al (52). However, we stress that it is always important to verify that the [ Fig.…”

Section: Measurements Of Sv O 2 -Nirs Resp and Sv O 2 -Nirs Vomentioning

confidence: 74%

“…For instance, proposed approaches involve a venous occlusion in a limb (13,39,55,56), tilting the patient's head down by 15 degrees (47), a partial jugular vein occlusion (15,54), or mechanical ventilation (52). In all these approaches, Sv O 2 is optically measured as the ratio between the increases in the HbO 2 concentration ([HbO 2 ]) and the total hemoglobin concentration (equal to [HbO 2 ] + [Hb], where [Hb] is deoxyhemoglobin concentration) induced by the local increase in venous blood volume.…”

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confidence: 99%

“…In all these approaches, Sv O 2 is optically measured as the ratio between the increases in the HbO 2 concentration ([HbO 2 ]) and the total hemoglobin concentration (equal to [HbO 2 ] + [Hb], where [Hb] is deoxyhemoglobin concentration) induced by the local increase in venous blood volume. To overcome the limitations of these methods, which can either be applied only to the limbs (venous occlusion method) or require an external perturbation (partial jugular vein occlusion, mechanical ventilation, and tilting methods), we propose an alternative approach that is an extension of the method of Wolf et al (52). This approach involves no external perturbations and is applicable to subjects who are breathing either spontaneously or synchronously with a metronome set at their average respiratory frequency.…”

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confidence: 99%

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Near-infrared spiroximetry: noninvasive measurements of venous saturation in piglets and human subjects

Franceschini

Boas

Zourabian

et al. 2002

Journal of Applied Physiology

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We present a noninvasive method to measure the venous oxygen saturation (Sv O 2 ) in tissues using near-infrared spectroscopy (NIRS). This method is based on the respiration-induced oscillations of the near-infrared absorption in tissues, and we call it spiroximetry (the prefix spiro means respiration). We have tested this method in three piglets (hind leg) and in eight human subjects (vastus medialis and vastus lateralis muscles). In the piglet study, we compared our NIRS measurements of the Sv O 2 (Sv O 2 -NIRS resp ) with the Sv O 2 of blood samples. Sv O 2 -NIRS resp and Sv O 2 of blood samples agreed well over the whole range of Sv O 2 considered (20-95%). The two measurements showed an average difference of 1.0% and a standard deviation of the difference of 5.8%. In the human study, we found a good agreement between Sv O 2 -NIRS resp and the Sv O 2 values measured with the NIRS venous occlusion method. Finally, in a preliminary test involving muscle exercise, Sv O 2 -NIRS resp showed an expected postexercise decrease from the initial baseline value and a subsequent recovery to baseline. Keywords tissue spectroscopy; frequency-domain; pulse oximetry; hemoglobin saturation THE POSSIBILITY OF USING LIGHT to measure the oxygen saturation of hemoglobin in vivo has been explored since the 1940s (37). The feasibility of optical blood oximetry stems from the oxygenation dependence of the optical spectrum of hemoglobin. This is illustrated in Fig. 1, which shows the absorption spectra of 100 M hemoglobin for oxygen saturation values of 0,20,40, 60, 80, and 100%. The spectra of Fig. 1 were calculated from published values of the molar extinction coefficients of oxyhemoglobin (HbO 2 ) and deoxyhemoglobin (Hb) (43,53).Oxygen saturation of the pulmonary capillary blood in rabbits has been measured by using dynamic invasive techniques (48). Near-infrared light in the wavelength range from 700 to 900 nm results in a sufficient penetration depth for the noninvasive optical monitoring of skeletal muscle, cerebral gray matter, and breast tissue. As a result, near-infrared techniques allow a noninvasive assessment of hemoglobin saturation for a wide range of applications, such as the study of muscle metabolism (7,9,12,29,45), the diagnosis of vascular disorders NIH Public AccessAuthor Manuscript J Appl Physiol (1985). Author manuscript; available in PMC 2013 September 30.Published in final edited form as: J Appl Physiol (1985). 2002 January ; 92(1): 372-384. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript (2,20,32,33,44,49), functional brain imaging (3,10,24,30,35,50), and breast cancer detection (23,28,40,42,46).If near-infrared light is highly sensitive to the oxygen saturation of hemoglobin, then its large penetration depth inside tissues implies that the arterial, venous, and capillary compartments all contribute to the optical signal. The average hemoglobin oxygenation measured with near-infrared spectroscopy (NIRS) (19,34,41 Hb] at the breathing rate are mostly representative of the...

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Section: Measurements Of Sv O 2 -Nirs Resp and Sv O 2 -Nirs Vomentioning

confidence: 74%

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confidence: 99%

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confidence: 99%

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Near-infrared spiroximetry: noninvasive measurements of venous saturation in piglets and human subjects

Franceschini

Boas

Zourabian

et al. 2002

Journal of Applied Physiology

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“…650-950 nm) into tissue and measuring the diffusely back-reflected light, near-infrared spectroscopy (NIRS) is able to determine concentration changes of oxy-and deoxyhemoglobin ([O2Hb], [HHb]), which are related to changes in tissue hemodynamics and oxygenation [1][2][3][4]. For example, brain activity has been assessed using NIRS in adults [3,[5][6][7][8][9][10][11], infants and neonates [12][13][14][15], or animals [16][17][18]. During long-lasting NIRS recordings in particular, for example during sleep [19][20][21][22][23][24][25], artifacts in the NIRS data due to movements of the subjects are a common problem.…”

Section: Introductionmentioning

confidence: 99%

A New Approach for Automatic Removal of Movement Artifacts in Near-Infrared Spectroscopy Time Series by Means of Acceleration Data

et al. 2015

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Near-infrared spectroscopy (NIRS) enables the non-invasive measurement of changes in hemodynamics and oxygenation in tissue. Changes in light-coupling due to movement of the subject can cause movement artifacts (MAs) in the recorded signals. Several methods have been developed so far that facilitate the detection and reduction of MAs in the data. However, due to fixed parameter values (e.g., global threshold) none of these methods are perfectly suitable for long-term (i.e., hours) recordings or were not time-effective when applied to large datasets. We aimed to overcome these limitations by automation, i.e., data adaptive thresholding specifically designed for long-term measurements, and by introducing a stable long-term signal reconstruction. Our new technique ("acceleration-based movement artifact reduction algorithm", AMARA) is based on combining two methods: the "movement artifact reduction algorithm" (MARA, et al. Phys. Meas. 2010, 31, 649-662), and the "accelerometer-based motion artifact removal" (ABAMAR, Virtanen et al. J. Biomed. Opt. 2011, 16, 087005). We describe AMARA in detail and report about successful validation of the algorithm using empirical NIRS data, measured over the prefrontal cortex in adolescents during sleep. In addition, we compared the performance of AMARA to that of MARA and ABAMAR based on validation data.OPEN ACCESS Algorithms 2015, 8 1053 Scholkmann

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“…If the change is sufficiently rapid (seconds), it is amenable to an evaluation. Wolf et al used the finding that the OD signal varies synchronously with ventilation to determine venous oxygenation in neonates [30].…”

Section: Introductionmentioning

confidence: 99%

Monte Carlo simulation of light propagation in adult brain: influence of tissue blood content and indocyanine green

Niederer

Mudra

Keller

2008

Opto-Electronics Review

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Near-infrared spectroscopy (NIRS), applied to a human head, is a noninvasive method in neurointensive care to monitor cerebral hemodynamics and oxygenation. The method is particularly powerful when it is applied in combination with indocyanine green (ICG) as a tracer substance. In order to assess contributions to the measured optical density (OD) which are due to extracerebral circulation and disturb the clinically significant intracerebral signals, we simulated the light propagation in an anatomically representative model of the adult head derived from MRI measurements with the aid of Monte Carlo methods. Since the measured OD signal depends largely on the relative blood content in various transilluminated tissues, we weighted the calculated densities of the photon distribution under baseline conditions within the tissues with the changes and aberrations of the relative blood volumes which we expect to prevail under physiological conditions. Furthermore, the influence of the IGC dye as a tracer substance was assessed. We conclude that up to about different 70% of the measured OD signal may have its origin in the tissues of interest under optimal conditions, which is mainly due to the extrapolated high relative blood content of brain tissue along with the influence of ICG.

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Continuous noninvasive measurement of cerebral arterial and venous oxygen saturation at the bedside in mechanically ventilated neonates

Abstract: This new method has the potential for monitoring continuously, noninvasively, and simultaneously cerebral arterial and venous oxygen saturation and oxygen extraction in mechanically ventilated preterm infants.

Cited by 49 publications

References 4 publications

Near-infrared spiroximetry: noninvasive measurements of venous saturation in piglets and human subjects

Near-infrared spiroximetry: noninvasive measurements of venous saturation in piglets and human subjects

A New Approach for Automatic Removal of Movement Artifacts in Near-Infrared Spectroscopy Time Series by Means of Acceleration Data

Monte Carlo simulation of light propagation in adult brain: influence of tissue blood content and indocyanine green

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