Peripheral Near-Infrared Spectroscopy: Methodologic Aspects and a Systematic Review in Post-Cardiac Surgical Patients

Butler, Ethan; Chin, Melissa; Åneman, Anders

doi:10.1053/j.jvca.2016.07.035

Cited by 16 publications

(7 citation statements)

References 57 publications

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“…Taken together, these findings suggest a reduction in regional O 2 consumption, despite systemic O 2 ER resulting in the normal range in both groups of patients. Several factors may influence O 2 extraction and consumption in skeletal muscle, including the administration of sedative or vasopressor agents, a residual neuromuscular blockade in the first post-operative hours, and variations in body temperature [4, 35].…”

Section: Discussionmentioning

confidence: 99%

Tissue oxygen saturation changes and postoperative complications in cardiac surgery: a prospective observational study

et al. 2019

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BackgroundCardiac surgery with extracorporeal circulation (ECC) can induce microvascular dysfunction and tissue hypoperfusion. We hypothesized that the alterations in near-infrared spectroscopy (NIRS)-derived parameters would be associated with post-operative complications in cardiac surgery patients.MethodsProspective observational study performed at two University Hospitals. Ninety patients undergoing cardiac surgery with ECC were enrolled. The NIRS sensor was applied on the thenar eminence. A vascular occlusion test (VOT, 3-min ischemia) was performed at baseline (t0), at Intensive Care Unit (ICU) admission (t1), 3 (t2) and 6 (t3) hours later. Baseline tissue oxygen saturation (StO2), oxygen extraction rate and microvascular reactivity indices were calculated.ResultsIn the first hours after cardiac surgery, StO2 tended to increase (86% [80–89] at T3 versus 82% [79–86] at T0, p = ns), while both tissue oxygen extraction and microvascular reactivity tended to decrease, as indicated by increasing occlusion slope (− 8.1%/min [− 11.2 to − 7] at T3 versus − 11.2%/min [− 13.9 to − 7.9] at T0, p = ns) and decreasing recovery slope (1.9%/sec [1.1–2.9] at T3 versus 3.1%/sec [2.3–3.9] at T0, p = ns). No substantial differences were found in NIRS-derived variables and their changes over time between patients with complications and those without complications.ConclusionsPeripheral tissue oxygen extraction and microvascular reactivity were reduced during the first hours after cardiac surgery. NIRS-derived parameters were not able to predict complications in this population of cardiac surgery patients.

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Section: Discussionmentioning

confidence: 99%

Tissue oxygen saturation changes and postoperative complications in cardiac surgery: a prospective observational study

et al. 2019

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“…The local tissue oxygen consumption and vascular reactivity can be assessed by combining NIRS with an ischemic provocation test, the vascular occlusion test, VOT [6]. Several methods to perform a VOT have been described [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

The use of a vascular occlusion test combined with near-infrared spectroscopy in perioperative care: a systematic review

Niezen

Massari

Vos

et al. 2022

J Clin Monit Comput

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In the perioperative phase oxygen delivery and consumption can be influenced by different factors, i.e. type of surgery, anesthetic and cardiovascular drugs, or fluids. By combining near-infrared spectroscopy (NIRS) monitoring of regional tissue oxygen saturation (StO 2 ) with an ischemic provocation test, the vascular occlusion test (VOT), local tissue oxygen consumption and vascular reactivity at the microcirculatory level can be assessed. This systematic review aims to give an overview of the clinical information that VOT-derived NIRS values can provide in the perioperative period. After performing a systematic literature search, we included 29 articles. It was not possible to perform a meta-analysis because of the lack of comparable data and the observational nature of the majority of the included articles. We have clustered the found articles in two groups: non-cardiac surgery and cardiac surgery. We found that VOT-derived NIRS values show a wide variability and are influenced by the effects of anesthetics, cardiovascular drugs, fluids, and by the type of surgery. Additionally, deviations in VOT-derived NIRS values are also associated with adverse patients' outcomes, such as postoperative complications, prolonged mechanical ventilation and prolonged hospital length of stay. However, given the variability in VOT-derived NIRS values, clinical applicability remains elusive. Future clinical interventional trials might provide additional insight into the potential of VOT associated with NIRS to optimize perioperative care by targeting specific interventions to optimize the function of the microvasculature.

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“…Owing to near-infrared spectroscopy (NIRS) technology, the detection of microcirculatory dysfunction has become easier and non-invasive. Many studies have shown that the dynamic NIRS parameters that can be measured with a brief ischemic challenge are clinically more useful than static tissue oxygen saturation (StO 2 ) values 10 , 13 - 15 . A vascular occlusion test (VOT) is a method of observing the change in StO 2 after applying a tourniquet with a higher pressure than the patient's systolic blood pressure.…”

Section: Introductionmentioning

confidence: 99%

“…The StO 2 reduction rate (occlusion slope) during the ischemic period reflects oxygen extraction. The rate of StO 2 increase (recovery slope) during reperfusion after the release of the vascular occlusion reflects microvascular reactivity 10 , 13 , 14 .…”

Section: Introductionmentioning

confidence: 99%

Microvascular Reactivity Measured by Dynamic Near-infrared Spectroscopy Following Induction of General Anesthesia in Healthy Patients: Observation of Age-related Change

et al. 2021

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Peripheral Near-Infrared Spectroscopy: Methodologic Aspects and a Systematic Review in Post-Cardiac Surgical Patients

Cited by 16 publications

References 57 publications

Tissue oxygen saturation changes and postoperative complications in cardiac surgery: a prospective observational study

Tissue oxygen saturation changes and postoperative complications in cardiac surgery: a prospective observational study

The use of a vascular occlusion test combined with near-infrared spectroscopy in perioperative care: a systematic review

Microvascular Reactivity Measured by Dynamic Near-infrared Spectroscopy Following Induction of General Anesthesia in Healthy Patients: Observation of Age-related Change

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