Patients with increased intracranial pressure cannot be monitored using near infrared spectroscopy

Abstract

The hypothesis of this study was that with near infrared spectroscopy a decrease of the regional cerebral saturation would be detectable in patients with increased intracranial pressure. For this purpose, two study groups were compared: (A) eight healthy volunteers and (B) eight heart beating organ donors with brain stem herniation. The regional cerebral saturation was measured according to the developer's suggestions. Mean arterial pressure and peripheral pulse oximetry were recorded. The statistical comparison, using the unpaired t-test, revealed no significant differences for the regional cerebral saturation (p = 0.97) or for the mean arterial pressure or peripheral pulse oximetry between the groups. In both of the studied situations, no differences in the regional cerebral situation were detectable, even though the patient situations were completely antagonistic. Therefore, it is reasonable to discourage the use of the INVOS 3100 Cerebral Oxymeter to monitor patients with increased intracranial pressure indirectly.

Frequency domain near-infrared spectroscopy technique in the assessment of brain oxygenation: A validation study in live subjects and cadavers

“…Kytta and Ohman (1999) found that regional brain oxygenation as determined by CW-NIRS was normal in brain dead patients until mechanical ventilation stopped and arterial oxygen saturation decreased. Consistent with this, Muellner and Schramn (1998) indicated that CW-NIRS could not be used to accurately monitor organ donors with elevated intracranial pressure and brain stem herniation because SbO2 did not differ from systemic arterial oxygen saturation. The results of these studies raise questions regarding the ability of CW-NIRS to measure brain oxygenation in brain dead or dead patients.…”

Noninvasive Monitoring of Cerebral Oxygenation during Vasomotor Reactivity Tests by a New Near-Infrared Spectroscopy Device

“…NIRS has been used to monitor patients with head injuries [2, 3], during cerebral thrombolysis [4, 5], cardiopulmonal bypass [6, 7], and carotid endarterectomy [8, 9, 10]. However, validity and clinical significance are judged controversially [11, 12, 13, 14, 15]. …”

New trends in neuromonitoring patients with aneurysmal subarachnoid haemorrhage

“…Near infrared spectroscopi se bazira se na principu merenja promena u nivou cerebralne hemoglobin saturacije i na osnovu toga proce relativnih promena u cerebralnoj oksigenaciji i cerebralnom krvnom protoku 16 . Glavni nedostatak je to se ne mo'e napraviti razlika u protoku izmedju intra i ekstrakranialne cirkulacije, pa se ova metoda danas redje i koristi kao neuromonitoring bolesnika sa SAH-om 20 .…”