Cutaneous Vasoconstriction Affects Near-infrared Spectroscopy Determined Cerebral Oxygen Saturation during Administration of Norepinephrine

Sørensen, Henrik; Secher, Niels H.; Siebenmann, Christoph; Nielsen, Henning Bay; Kohl‐Bareis, Matthias; Lundby, Carsten; Rasmussen, Peter

doi:10.1097/aln.0b013e3182605afe

Cited by 133 publications

(96 citation statements)

References 39 publications

(54 reference statements)

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“…The authors suggested that both norepinephrine and hyperthermia affected skin oxygenation and subsequently influenced SctO 2 readings by reducing the values. 17 There are no regulatory standards thus far with respect to error in the precision of cerebral oximetry readings. Nevertheless, when examining the pulse oximeter, a monitor similar in design to a cerebral oximeter, the regulatory standards permit SpO 2 values to vary from baseline up to 3.5% according to the U.S. Food and Drug Administration and up to 4% according to the International Organization for Standardization.…”

Section: Extracranial Contamination Of Nirs 27mentioning

confidence: 99%

Extracranial contamination in the INVOS 5100C versus the FORE-SIGHT ELITE cerebral oximeter: a prospective observational crossover study in volunteers

Greenberg

Murphy

Shear

et al. 2015

Can J Anesth/J Can Anesth

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Purpose Previous studies have found that most cerebral oximeters are subject to inaccuracies secondary to extracranial contamination of the cerebral oximetric signals. We hypothesized that the more advanced secondgeneration FORE-SIGHT ELITE cerebral oximeter would be significantly less affected by extracranial tissue hypoxemia than the more widely used first-generation INVOS TM 5100C monitor. Methods Twenty healthy volunteers aged 18-45 yr had the INVOS and FORE-SIGHT probes placed on their forehead in a random sequence while in the supine position. A pneumatic head cuff was then placed around each volunteer's head just below both the oximeter and a concomitantly placed scalp forehead pulse oximeter probe. The subjects' scalp cerebral oxygen saturation (SctO 2 ) values were measured and compared using the two different devices in sequence, both before and after scalp tissue ischemia was induced by the pneumatic cuff. Results Extracranial ischemia resulted in a significant reduction in SctO 2 values from baseline in both devices. The INVOS 5100C recorded a median [interquartile range] decrease in SctO 2 from baseline at five minutes of 15.1% [12.6 -17.6], while that recorded by the FORESIGHT ELITE device was 8.6% [4.0 -12.3] at five minutes (median difference, 7.9%; 99% confidence interval, 1.9 to 16.5; P = 0.002). Conclusion Updated technological algorithms employed in the FORE-SIGHT ELITE cerebral oximeter may be responsible for less extracranial contamination than was observed in the previous-generation INVOS 5100C device. The impact that this extracranial contamination may have on the clinical use of these devices remains to be determined. RésuméObjectif Selon les études réalisées par le passé, la plupart des oxymètres cérébraux sont sujets à des inexactitudes suite à une contamination extracrânienne des signaux d'oxymétrie cérébrale. Nous avons émis l'hypothèse que l'oxymètre cérébral FORE-SIGHT ELITE, l'oxymètre cérébral de deuxième génération le plus innovant à ce jour, serait significativement moins affecté par l'hypoxémie des tissus extracrâniens que le moniteur de première génération INVOS TM 5100C, plus répandu.

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Section: Extracranial Contamination Of Nirs 27mentioning

confidence: 99%

Extracranial contamination in the INVOS 5100C versus the FORE-SIGHT ELITE cerebral oximeter: a prospective observational crossover study in volunteers

Greenberg

Murphy

Shear

et al. 2015

Can J Anesth/J Can Anesth

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“…In this study, blood pressure was unaffected during phenyleprine infusion. Similarly, intracarotid injection of sodium nitroprusside in humans does not increase cerebral blood flow [7].…”

Section: H P Grocottmentioning

confidence: 99%

Cerebral oxygenation and vascular resistance changes during cardiopulmonary bypass – where is the proof?

Grocott

2017

Anaesthesia

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“…Moreover, an epior a subdural haematoma can have adverse effects; in such cases, the cerebral cortex is likely to be beyond the range of radiation emitted by the sensor. The other factors limiting the value of brain saturation measurements involve brain oedema and local disorders of perfusion resulting from the presence of atherosclerotic lesions or arterial embolism [9].…”

Section: Limitations Of Nirs For Assessment Of Brain Saturationmentioning

confidence: 99%

“…In cases of cerebral cortex atrophy, often observed in elderly patients, the range of proton beam can be insufficient to assess cortex oxygenation ( Fig.2) [9]. It has been found that NIRS monitor readings in the elderly can paradoxically decrease during cooling and increase during re-warming (brain cooling reactivity), which indicates the presence of significant cortical atrophies and limits the possibility of brain oximetry interpretation [5].…”

Section: Limitations Of Nirs For Assessment Of Brain Saturationmentioning

confidence: 99%

Tissue oximetry in anaesthesia and intensive care

Biedrzycka¹,

Lango²

2016

Anaesthesiol Intensive Ther

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Conventional monitoring during surgery and intensive care is not sufficiently sensitive to detect acute changes in vital organs perfusion, while its good quality is critical for maintaining their function. Disturbed vital organ perfusion may lead to the development of postoperative complications, including neurological sequel and renal failure. Nearinfra-red spectroscopy (NIRS) represents one of up-to-date techniques of patient monitoring which is commonly used for the assessment of brain oximetry in thoracic aorta surgery, and -increasingly more often -in open-heart surgery. Algorithms for maintaining adequate brain saturation may result in a decrease of neurological complications and cognitive dysfunction following cardiac surgery. The assessment of kidney and visceral perfusion with tissue oximetry is gaining increasing interest during pediatric cardiac surgery. Attempts at decreasing complications by the use of brain oximetry during carotid endarterectomy, as well as thoracic and abdominal surgery demonstrated conflicting results. In recent years NIRS technique was proposed as a tool for muscle perfusion assessment under short term ischemia and reperfusion, referred to as vascular occlusion test (VOT). This monitoring extension allows for the identification of early disturbances in tissue perfusion. Results of recent studies utilizing VOT suggest that the muscle saturation decrease rate is reduced in septic shock patients, while decreased speed of saturation recovery on reperfusion is related to disturbed microcirculation. Being non-invasive and feasible technique, NIRS offers an improvement of preoperative risk assessment in cardiac surgery and promises more comprehensive intraoperative and ICU patient monitoring allowing for better outcome.

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Cutaneous Vasoconstriction Affects Near-infrared Spectroscopy Determined Cerebral Oxygen Saturation during Administration of Norepinephrine

Abstract: The results confirm that spatially resolved near-infrared spectroscopy detects cerebral deoxygenation with systemic hypoxic exposure and hyperventilation. However, a commonly used vasopressor norepinephrine disturbs skin oxygen saturation to an extent that influences scO2.

Cited by 133 publications

References 39 publications

Extracranial contamination in the INVOS 5100C versus the FORE-SIGHT ELITE cerebral oximeter: a prospective observational crossover study in volunteers

Extracranial contamination in the INVOS 5100C versus the FORE-SIGHT ELITE cerebral oximeter: a prospective observational crossover study in volunteers

Cerebral oxygenation and vascular resistance changes during cardiopulmonary bypass – where is the proof?

Tissue oximetry in anaesthesia and intensive care

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