Brain oxygenation monitoring during cardiopulmonary bypass by near infrared spectroscopy

A Review of Cerebral Hemodynamics During Sleep Using Near-Infrared Spectroscopy

Investigating cerebral hemodynamic changes during regular sleep cycles and sleep disorders is fundamental to understanding the nature of physiological and pathological mechanisms in the regulation of cerebral oxygenation during sleep. Although sleep neuroimaging methods have been studied and have been well-reviewed, they have limitations in terms of technique and experimental design. Neurologists are convinced that Near-infrared spectroscopy (NIRS) provides essential information and can be used to assist the assessment of cerebral hemodynamics, and numerous studies regarding sleep have been carried out based on NIRS. Thus, a brief historical overview of the sleep studies using NIRS will be helpful for the biomedical students, academicians, and engineers to better understand NIRS from various perspectives. In this study, the existing literature on sleep studies is reviewed, and an overview of the NIRS applications is synthesized and provided. The paper first reviews the application scenarios, as well as the patterns of fluctuation of NIRS, which includes the investigation in regular sleep and sleep-disordered breathing. Various factors such as different sleep stages, populations, and degrees of severity were considered. Furthermore, the experimental design and signal processing, as well as the regulation mechanisms involved in regular and pathological sleep, are investigated and discussed. The strengths and weaknesses of the existing NIRS applications are addressed and presented, which can direct further NIRS analysis and utilization.

Clinical evaluation of time-resolved spectroscopy by measuring cerebral hemodynamics during cardiopulmonary bypass surgery

We developed a three-wavelength time-resolved spectroscopy (TRS) system, which allows quantitative measurement of hemodynamics within relatively large living tissue. We clinically evaluated this TRS system by monitoring cerebral circulation during cardiopulmonary bypass surgery. Oxyhemoglobin, deoxyhemoglobin, total hemoglobin and oxygen saturation (SO(2)) were determined by TRS on the left forehead attached with an optode spacing of 4 cm. We also simultaneously monitored jugular venous oxygen saturation (SjvO(2)) and arterial blood hematocrit (Hct) using conventional methods. The validity and usefulness of the TRS system were assessed by comparing parameters obtained with the TRS and conventional methods. Although the changes in SO(2) were lower than those in SjvO(2), SO(2) obtained by TRS paralleled the fluctuations in SjvO(2), and a good correlation between these values was observed. The only exceptions occurred during the perfusion period. Moreover, there was a good correlation between tHb and Hct values (r(2)=0.63). We concluded that time-resolved spectroscopy reflected the conditions of cerebral hemodynamics of patients during surgical operations.

Cerebral hemodynamics evaluation by near-infrared time-resolved spectroscopy: Correlation with simultaneous positron emission tomography measurements

We compared pharmacologically-perturbed hemodynamic parameters (cerebral blood volume; CBV, and flow; CBF) by acetazolamide administration in six healthy human subjects studied with positron emission tomography (PET) and near-infrared (NIR) time-resolved spectroscopy (TRS) simultaneously to investigate whether NIR-TRS could measure in vivo hemodynamics in the brain tissue quantitatively. Simultaneously with the PET measurements, TRS measurements were performed at the forehead with four different optode spacing from 2 cm to 5 cm. Total hemoglobin and oxygen saturation (SO2) measured by TRS significantly increased after administration of acetazolamide at any optode spacing in all subjects. In PET study, CBV and CBF were estimated in the following three volumes of interest (VOIs) determined on magnetic resonance images, VOI1: scalp and skull, VOI2: gray matter region, VOI3: gray and white matter regions. Acetazolamide treatment elevated CBF and CBV significantly in VOI2 and VOI3 but VOI1. TRS-derived CBV was more strongly correlated with PET-derived counterpart in VOI2 and VOI3 when the optode spacing was above 4 cm, although optical signal from cerebral tissue could be caught with any optode spacing. As to increase of the CBV, 4 cm of optode spacing correlated best with VOI2. To support the result of TRS-PET experiment, we also estimated the contribution ratios of intracerebral tissue to observed absorption change based on diffusion theory. The contribution ratios at 4 cm were estimated as follows: 761 nm: 50%, 791 nm: 72%, 836 nm: 70%. These results demonstrated that NIR-TRS with 4 cm of optode spacing could measure cerebral hemodynamic responses optimally and quantitatively.