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Kappacher C, Schwarz B, Rainer M, Huck CW. Unveiling the synergy of NIRS and enrichment technologies: A comprehensive review of in-sorbent-based detection and quantification strategies. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2024; 310:123955. [PMID: 38306925 DOI: 10.1016/j.saa.2024.123955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/16/2024] [Accepted: 01/21/2024] [Indexed: 02/04/2024]
Abstract
This comprehensive review paper aims to captivate the applicability of in-sorbent detection, where near-infrared spectroscopy (NIRS) converges with enrichment technologies. For this purpose, we collected and summarized information regarding the combination of several sophisticated analytical enrichment techniques with NIRS to further explore and develop this synergistic approach. Peer-reviewed publications, matching the criteria of in situ NIR measurements prior analyte elution, have been collected, investigated, and concluded within this review. Investigations according to used materials, commercial or self-made, composition, organic or inorganic and applied analytical methodologies have been carried out. Applications extending over a multitude of chemical fields, from environmental to medicinal applications. As this review concludes, the combination of these techniques further expands the applicability of NIRS and moreover tries to solve the long-standing issue of the comparably low sensitivity regarding this vibrational technique.
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Affiliation(s)
- Christoph Kappacher
- Institute of Analytical Chemistry and Radiochemistry, Leopold-Franzens-University Innsbruck, Innrain 80/82, A-6020 Innsbruck, Austria
| | - Benedikt Schwarz
- Institute of Analytical Chemistry and Radiochemistry, Leopold-Franzens-University Innsbruck, Innrain 80/82, A-6020 Innsbruck, Austria
| | - Matthias Rainer
- Institute of Analytical Chemistry and Radiochemistry, Leopold-Franzens-University Innsbruck, Innrain 80/82, A-6020 Innsbruck, Austria
| | - Christian W Huck
- Institute of Analytical Chemistry and Radiochemistry, Leopold-Franzens-University Innsbruck, Innrain 80/82, A-6020 Innsbruck, Austria.
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2
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Pedersen SS, Sørensen MK, Olsen MH, Stisen ZR, Lund A, Møller K, Skjøth-Rasmussen J, Moltke FB, Meyhoff CS. Near-infrared spectroscopy to measure brain oxygenation: A comparison of measurements on the skin, skull and dura mater. Acta Anaesthesiol Scand 2024; 68:188-194. [PMID: 37877464 DOI: 10.1111/aas.14344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 01/09/2023] [Accepted: 09/30/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND The reliability of near-infrared spectroscopy (NIRS) for measuring cerebral oxygenation (ScO2 ) is controversial due to the possible contamination from extracranial tissues. We compared ScO2 measured with the NIRS optode on the forehead, the skull and the dura mater in anaesthetised patients undergoing craniotomy. We hypothesised that ScO2 measured directly on the skull and the dura mater would differ from ScO2 measured on the skin. METHODS This prospective observational study included 17 adult patients scheduled for elective craniotomy. After induction of general anaesthesia, ScO2 was measured on the forehead skin, as well as on the skull and on the dura mater in the surgical field. The primary comparison was the difference in ScO2 measured on the dura mater and on ScO2 measured on the skin; secondary comparisons were the differences in ScO2 on the skull and ScO2 on the skin and the dura mater, respectively. Data were described with median (5%-95% range) and analysed with the Wilcoxon signed-rank test. RESULTS ScO2 values on the dura mater were obtained in 11 patients, and median ScO2 (48%, 29%-95%) did not differ significantly from ScO2 on the skin (73%, 49%-92%; p = .052), median difference -25% (-35.6% to -1.2%). ScO2 on the skull (N = 16) was lower than that on the skin (63% [43%-79%] vs. 75% [61%-94%]; p = .0002), median difference -10% (-20.8 to -3.0). CONCLUSION In adults undergoing craniotomy, NIRS-based ScO2 measured on the dura mater did not reach statistically significantly lower values than ScO2 measured on the skin, whereas values on the skull were lower than on the skin, indicating a contribution from scalp tissue to the signal.
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Affiliation(s)
- Sofie S Pedersen
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Martin Kryspin Sørensen
- Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Markus Harboe Olsen
- Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Zara R Stisen
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Anton Lund
- Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Kirsten Møller
- Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jane Skjøth-Rasmussen
- Department of Neurosurgery, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Finn B Moltke
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Christian S Meyhoff
- Department of Anaesthesia and Intensive Care, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Copenhagen Center for Translational Research, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
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Qi Y, Zhang R, Rajarahm P, Zhang S, Ebrahim Attia AB, Bi R, Olivo M. Simultaneous Dual-Wavelength Source Raman Spectroscopy with a Handheld Confocal Probe for Analysis of the Chemical Composition of In Vivo Human Skin. Anal Chem 2023; 95:5240-5247. [PMID: 36930570 PMCID: PMC10062338 DOI: 10.1021/acs.analchem.2c05065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023]
Abstract
Confocal Raman spectroscopy (CRS) is a powerful tool that has been widely used for biological tissue analysis because of its noninvasive nature, high specificity, and rich biochemical information. However, current commercial CRS systems suffer from limited detection regions (450-1750 cm-1), bulky sizes, nonflexibilities, slow acquisitions by consecutive excitations, and high costs if using a Fourier transform (FT) Raman spectroscopy with an InGaAs detector, which impede their adoption in clinics. In this study, we developed a portable CRS system with a simultaneous dual-wavelength source and a miniaturized handheld probe (120 mm × 60 mm × 50 mm) that can acquire spectra in both fingerprint (FP, 450-1750 cm-1) and high wavenumber (HW, 2800-3800 cm-1) regions simultaneously. An innovative design combining 671 and 785 nm lasers for simultaneous excitation through a compact and high-efficiency (>90%) wavelength combiner was implemented. Moreover, to decouple the fused FP and HW spectra, a first-of-its-kind precise Raman spectra separation algorithm (PRSSA) was developed based on the maximum a posteriori probability (MAP) estimate. The accuracy of spectra separation was greater than 99%, demonstrated in both phantom experiments and in vivo human skin measurements. The total data acquisition time was reduced by greater than 50% compared to other CRS systems. The results proved our proposed CRS system and PRSSA's superior capability in fast and ultrawideband spectra acquisition will significantly improve the integration of CRS in the clinical workflow.
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Affiliation(s)
- Yi Qi
- Institute
of Bioengineering and Bioimaging, A*STAR, Singapore 138667, Singapore
| | - Ruochong Zhang
- Institute
of Bioengineering and Bioimaging, A*STAR, Singapore 138667, Singapore
| | | | - Shuyan Zhang
- Institute
of Bioengineering and Bioimaging, A*STAR, Singapore 138667, Singapore
| | | | - Renzhe Bi
- Institute
of Bioengineering and Bioimaging, A*STAR, Singapore 138667, Singapore
| | - Malini Olivo
- Institute
of Bioengineering and Bioimaging, A*STAR, Singapore 138667, Singapore
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Hermans T, Carkeek K, Dereymaeker A, Jansen K, Naulaers G, Van Huffel S, De Vos M. Partial wavelet coherence as a robust method for assessment of neurovascular coupling in neonates with hypoxic ischemic encephalopathy. Sci Rep 2023; 13:457. [PMID: 36627381 PMCID: PMC9832127 DOI: 10.1038/s41598-022-27275-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 12/29/2022] [Indexed: 01/12/2023] Open
Abstract
In neonates with hypoxic ischemic encephalopathy, the computation of wavelet coherence between electroencephalogram (EEG) power and regional cerebral oxygen saturation (rSO2) is a promising method for the assessment of neurovascular coupling (NVC), which in turn is a promising marker for brain injury. However, instabilities in arterial oxygen saturation (SpO2) limit the robustness of previously proposed methods. Therefore, we propose the use of partial wavelet coherence, which can eliminate the influence of SpO2. Furthermore, we study the added value of the novel NVC biomarkers for identification of brain injury compared to traditional EEG and NIRS biomarkers. 18 neonates with HIE were monitored for 72 h and classified into three groups based on short-term MRI outcome. Partial wavelet coherence was used to quantify the coupling between C3-C4 EEG bandpower (2-16 Hz) and rSO2, eliminating confounding effects of SpO2. NVC was defined as the amount of significant coherence in a frequency range of 0.25-1 mHz. Partial wavelet coherence successfully removed confounding influences of SpO2 when studying the coupling between EEG and rSO2. Decreased NVC was related to worse MRI outcome. Furthermore, the combination of NVC and EEG spectral edge frequency (SEF) improved the identification of neonates with mild vs moderate and severe MRI outcome compared to using EEG SEF alone. Partial wavelet coherence is an effective method for removing confounding effects of SpO2, improving the robustness of automated assessment of NVC in long-term EEG-NIRS recordings. The obtained NVC biomarkers are more sensitive to MRI outcome than traditional rSO2 biomarkers and provide complementary information to EEG biomarkers.
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Affiliation(s)
- Tim Hermans
- Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium.
| | - Katherine Carkeek
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium ,grid.48769.340000 0004 0461 6320Neonatal Intensive Care Unit, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Anneleen Dereymaeker
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Katrien Jansen
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Child Neurology, UZ Leuven, Leuven, Belgium
| | - Gunnar Naulaers
- grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium ,grid.410569.f0000 0004 0626 3338Neonatal Intensive Care Unit, UZ Leuven, Leuven, Belgium
| | - Sabine Van Huffel
- grid.5596.f0000 0001 0668 7884Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium
| | - Maarten De Vos
- grid.5596.f0000 0001 0668 7884Department of Electrical Engineering (ESAT), STADIUS, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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Philipopoulos GP, Sharareh B, Ganesan G, Tromberg BJ, O’Sullivan TD, Schwarzkopf R. Characterizing tourniquet induced hemodynamics during total knee arthroplasty using diffuse optical spectroscopy. J Orthop Res 2023; 41:104-114. [PMID: 35289956 PMCID: PMC9475493 DOI: 10.1002/jor.25327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023]
Abstract
Tourniquet use creates a reduced blood surgical field during total knee arthroplasty (TKA), however, prolonged ischemia may cause postoperative tourniquet complications. To understand the effects of tourniquet-induced ischemia, we performed a prospective observational study using quantitative broadband diffuse optical spectroscopy (DOS) to measure tissue hemodynamics and water and lipid concentrations before, during, and after tourniquet placement in subjects undergoing TKA. Data was collected for 6 months and, of the total subjects analyzed (n = 24), 22 were primary TKAs and 2 were revision TKA cases. We specifically investigated tourniquet-induced hemodynamics based upon subject-specific tissue composition and observed a significant relationship between the linear rate of deoxygenation after tourniquet inflation and water/lipid ratio (W/L, p < 0.0001) and baseline somatic tissue oxygen saturation, StO2 (p = 0.05). Subjects with a low W/L ratio exhibited a lower tissue metabolic rate of oxygen consumption, (tMRO2 ) (p = 0.008). Changes in deoxyhemoglobin [HbR] (p = 0.009) and lipid fraction (p = 0.001) were significantly different between high and low W/L subject groups during deoxygenation. No significant differences were observed for hemodynamics during reperfusion and total tourniquet time was neither significantly related to the hemodynamic hyperemic response (p = 0.73) nor the time to max StO2 after tourniquet release (p = 0.57). In conclusion, we demonstrate that DOS is capable of real-time monitoring of tissue hemodynamics distal to the tourniquet during TKA, and that tissue composition should be considered. DOS may help surgeons stratify hemodynamics based upon tissue composition and eventually aid the preoperative risk assessment of vascular occlusions from tourniquet use during TKA.
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Affiliation(s)
- George P. Philipopoulos
- University of California, Irvine, Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, 1002 Health Sciences Road, Irvine, CA 92617, USA
| | - Behnam Sharareh
- University of Washington, Department of Orthopaedics and Sport Medicine, Seattle, WA, USA
| | - Goutham Ganesan
- University of California, Irvine, Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, 1002 Health Sciences Road, Irvine, CA 92617, USA
- University of California Irvine, Institute for Clinical and Translation Science, 843 Hewitt Hall, Irvine, USA, 92617
| | - Bruce J. Tromberg
- University of California, Irvine, Beckman Laser Institute and Medical Clinic, Laser Microbeam and Medical Program, 1002 Health Sciences Road, Irvine, CA 92617, USA
| | - Thomas D. O’Sullivan
- University of Notre Dame, Department of Electrical Engineering, 275 Fitzpatrick Hall, Notre Dame, IN 46556 USA
| | - Ran Schwarzkopf
- NYU Langone Orthopaedic Hospital, Hospital for Joint Diseases, 301 East 17 Street, New York, NY 10003 USA
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Sandru S, Buzescu D, Zahiu CDM, Spataru A, Panaitescu AM, Isac S, Balan CI, Zagrean AM, Pavel B. Near-Infrared Spectroscopy Usefulness in Validation of Hyperventilation Test. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101396. [PMID: 36295560 PMCID: PMC9607377 DOI: 10.3390/medicina58101396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/23/2022] [Accepted: 09/28/2022] [Indexed: 11/16/2022]
Abstract
Background: The hyperventilation test is used in clinical practice for diagnosis and therapeutic purposes; however, in the absence of a standardized protocol, the procedure varies significantly, predisposing tested subjects to risks such as cerebral hypoxia and ischemia. Near-infrared spectroscopy (NIRS), a noninvasive technique performed for cerebral oximetry monitoring, was used in the present study to identify the minimum decrease in the end-tidal CO2 (ETCO2) during hyperventilation necessary to induce changes on NIRS. Materials and Methods: We recruited 46 volunteers with no preexisting medical conditions. Each subject was asked to breathe at a baseline rate (8−14 breaths/min) for 2 min and then to hyperventilate at a double respiratory rate for the next 4 min. The parameters recorded during the procedure were the regional cerebral oxyhemoglobin and deoxyhemoglobin concentrations via NIRS, ETCO2, and the respiratory rate. Results: During hyperventilation, ETCO2 values dropped (31.4 ± 12.2%) vs. baseline in all subjects. Changes in cerebral oximetry were observed only in those subjects (n = 30) who registered a decrease (%) in ETCO2 of 37.58 ± 10.34%, but not in the subjects (n = 16) for which the decrease in ETCO2 was 20.31 ± 5.6%. According to AUC-ROC analysis, a cutoff value of ETCO2 decrease >26% was found to predict changes in oximetry (AUC-ROC = 0.93, p < 0.0001). Seven subjects reported symptoms, such as dizziness, vertigo, and numbness, throughout the procedure. Conclusions: The rise in the respiratory rate alone cannot effectively predict the occurrence of a cerebral vasoconstrictor response induced by hyperventilation, and synchronous ETCO2 and cerebral oximetry monitoring could be used to validate this clinical test. NIRS seems to be a useful tool in predicting vasoconstriction following hyperventilation.
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Affiliation(s)
- Stefan Sandru
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Dan Buzescu
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Carmen Denise Mihaela Zahiu
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (C.D.M.Z.); (B.P.)
| | - Ana Spataru
- Department of Critical Care, King’s College Hospital Denmark Hill, London SE5 9RS, UK
| | - Anca Maria Panaitescu
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital Bucharest, 011171 Bucharest, Romania
- Department of Obstetrics and Gynecology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Sebastian Isac
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Cosmin Ion Balan
- Department I of Cardiovascular Anesthesiology and Intensive Care, “Prof. C. C Iliescu” Emergency Institute for Cardiovascular Diseases, 050474 Bucharest, Romania
| | - Ana-Maria Zagrean
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Pavel
- Department of Functional Sciences, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: (C.D.M.Z.); (B.P.)
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Tribuddharat S, Ngamsaengsirisup K, Mahothorn P, Sathitkarnmanee T. Correlation and agreement of regional cerebral oxygen saturation measured from sensor sites at frontal and temporal areas in adult patients undergoing cardiovascular anesthesia. PeerJ 2022; 10:e14058. [PMID: 36128196 PMCID: PMC9482766 DOI: 10.7717/peerj.14058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 08/25/2022] [Indexed: 01/20/2023] Open
Abstract
Background The function and viability of the brain depend on adequate oxygen supply. A decrease in cerebral blood supply causing cerebral desaturation may lead to many neurological complications. Direct measurement of regional cerebral oxygen saturation (rScO2) assists in early detection and management. Near-infrared spectroscopy (NIRS) has been introduced for measuring rScO2. A pair of sensors are attached to the right and left forehead. However, there are some situations where the forehead of the patient is not accessible for sensor attachment (e.g., neurosurgery involving the frontal area; a bispectral index (BIS) sensor already attached, or a wound to the forehead); therefore, alternate sites for sensor attachment are required. The temporal area was proposed as an alternate site. The objective of this study was to assess the correlation and agreement of rScO2 measured at the forehead vs. the temporal area. Methods Adult patients undergoing cardiothoracic or vascular surgery were monitored for rScO2 using two pairs of ForeSight sensors. The first pair (A1 and A2) were attached to the right and left forehead, while the second pair (B1 and B2) were attached to the right and left temporal area. The rScO2 values measured from A1 vs. B1 and A2 vs. B2 were assessed for correlation and agreement using the Bland-Altman analysis. Results Data from 19 patients with 14,364 sets of data were analyzed. The data from A1 vs. B1 and A2 vs. B2 showed moderate positive correlation (r = 0.627; P < 0.0001 and r = 0.548; P < 0.0001). The biases of A1 vs. B1 and A2 vs. B2 were -2.3% (95% CI [-2.5 to -2.2]; P < 0.0001) and 0.7% (95% CI [0.6-0.8]; P < 0.0001). The lower and upper limits of agreement of A1 vs. B1 were -17.5% (95% CI [-17.7 to -17.3]) and 12.8% (95% CI [12.6-13.0]). The lower and upper limits of agreement of A2 vs. B2 were -14.6% (95% CI [-14.8 to -14.4]) and 16.0% (95% [CI 15.8-16.3]). Conclusions The rScO2 values measured from sensors at the frontal and temporal areas show a moderate correlation with sufficiently good agreement. The temporal area may be an alternative to the frontal area for cerebral oximetry monitoring.
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Infrared Spectroscopy–Quo Vadis? APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Given the exquisite capability of direct, non-destructive label-free sensing of molecular transitions, IR spectroscopy has become a ubiquitous and versatile analytical tool. IR application scenarios range from industrial manufacturing processes, surveillance tasks and environmental monitoring to elaborate evaluation of (bio)medical samples. Given recent developments in associated fields, IR spectroscopic devices increasingly evolve into reliable and robust tools for quality control purposes, for rapid analysis within at-line, in-line or on-line processes, and even for bed-side monitoring of patient health indicators. With the opportunity to guide light at or within dedicated optical structures, remote sensing as well as high-throughput sensing scenarios are being addressed by appropriate IR methodologies. In the present focused article, selected perspectives on future directions for IR spectroscopic tools and their applications are discussed. These visions are accompanied by a short introduction to the historic development, current trends, and emerging technological opportunities guiding the future path IR spectroscopy may take. Highlighted state-of-the art implementations along with novel concepts enhancing the performance of IR sensors are presented together with cutting-edge developments in related fields that drive IR spectroscopy forward in its role as a versatile analytical technology with a bright past and an even brighter future.
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Sirota GL, Litmanovitz I, Vider C, Arnon S, Moore SS, Grinblatt E, Levkovitz O, Bauer Rusek S. Regional Splanchnic Oxygenation during Continuous versus Bolus Feeding among Stable Preterm Infants. CHILDREN 2022; 9:children9050691. [PMID: 35626866 PMCID: PMC9139727 DOI: 10.3390/children9050691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/24/2022] [Accepted: 05/03/2022] [Indexed: 11/16/2022]
Abstract
Introduction: There is no agreement regarding the best method for tube-feeding preterm infants. Few studies, to date, have evaluated the influence of different methods of enteral feeding on intestinal oxygenation. The use of near-infrared spectroscopy (NIRS) has permitted the noninvasive measurement of splanchnic regional oxygenation (rSO2S) in different clinical conditions. The aim of this prospective, single-center study was to compare rSO2S during continuous versus bolus feeding among stable preterm infants. Methods: Twenty-one preterm infants, less than 32 weeks gestation and appropriate for gestational age, were enrolled. All infants were clinically stable and on full tube feedings. Each infant received a bolus feeding initially (20 min duration), and after 3 h, a continuous feeding (5 h duration). Infants were evaluated 30 min before and 30 min after the bolus and continuous feedings. The regional splanchnic saturation (rSO2S) was measured using near-infrared spectroscopy (NIRS) technology and systemic saturation was measured with pulse oximetry. From these measurements, we calculated the splanchnic fractional oxygen extraction ratio (FOES) for each of the four intervals. Results: rSO2S decreased after continuous vs. bolus feeding (p = 0.025), while there was a trend toward decreased SaO2 after bolus feeding (p = 0.055). The FOES, which reflects intestinal oxygen extraction, was not affected by the feeding mode (p = 0.129). Discussion/Conclusion: Continuous vs. bolus feeding decreases rSO2S but does not affect oxygen extraction by intestinal tissue; after bolus feeding there was a trend towards decreased systemic saturation.
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Affiliation(s)
- Gisela Laura Sirota
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel; (I.L.); (S.A.); (S.S.M.); (E.G.); (O.L.); (S.B.R.)
- Correspondence: ; Tel.: +972-50-538-2266
| | - Ita Litmanovitz
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel; (I.L.); (S.A.); (S.S.M.); (E.G.); (O.L.); (S.B.R.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Carmel Vider
- Department of Pediatrics, Meir Medical Center, Kfar-Saba 4428164, Israel;
| | - Shmuel Arnon
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel; (I.L.); (S.A.); (S.S.M.); (E.G.); (O.L.); (S.B.R.)
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
| | - Shiran Sara Moore
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel; (I.L.); (S.A.); (S.S.M.); (E.G.); (O.L.); (S.B.R.)
| | - Eynit Grinblatt
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel; (I.L.); (S.A.); (S.S.M.); (E.G.); (O.L.); (S.B.R.)
| | - Orly Levkovitz
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel; (I.L.); (S.A.); (S.S.M.); (E.G.); (O.L.); (S.B.R.)
| | - Sofia Bauer Rusek
- Department of Neonatology, Meir Medical Center, Kfar-Saba 4428164, Israel; (I.L.); (S.A.); (S.S.M.); (E.G.); (O.L.); (S.B.R.)
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Huang J, Wang Z, Fan L, Ma S. A review of wheat starch analyses: Methods, techniques, structure and function. Int J Biol Macromol 2022; 203:130-142. [PMID: 35093434 DOI: 10.1016/j.ijbiomac.2022.01.149] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/28/2021] [Accepted: 01/23/2022] [Indexed: 01/31/2023]
Abstract
Wheat starch has received much attention as an important source of dietary energy for humans, an interesting carbohydrate and a polymeric material. The understanding of the structure and function of wheat starch has always been accompanied by newer technological tools. On the one hand, the general knowledge of wheat starch is constantly being enriched. On the other hand, an increasing number of studies are trying to add new insights to what is already known from two frontier perspectives, namely, wheat starch supramolecular structures and wheat starch fine structures (CLDs). This review describes the structure and function of wheat starch from the perspective of wheat starch analysis techniques (instruments).
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Affiliation(s)
- Jihong Huang
- College of Food and Medicine, Xuchang University, Xuchang, Henan 461000, China; College of Food Science and Engineering, Henan University of Technology, Zhengzhou, Henan 450001, China.
| | - Zhen Wang
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, Henan 450001, China
| | - Ling Fan
- College of Food and Medicine, Xuchang University, Xuchang, Henan 461000, China
| | - Sen Ma
- College of Food Science and Engineering, Henan University of Technology, Zhengzhou, Henan 450001, China.
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11
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Marillier M, Gruet M, Bernard AC, Verges S, Neder JA. The Exercising Brain: An Overlooked Factor Limiting the Tolerance to Physical Exertion in Major Cardiorespiratory Diseases? Front Hum Neurosci 2022; 15:789053. [PMID: 35126072 PMCID: PMC8813863 DOI: 10.3389/fnhum.2021.789053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 12/28/2021] [Indexed: 12/18/2022] Open
Abstract
“Exercise starts and ends in the brain”: this was the title of a review article authored by Dr. Bengt Kayser back in 2003. In this piece of work, the author highlights that pioneer studies have primarily focused on the cardiorespiratory-muscle axis to set the human limits to whole-body exercise tolerance. In some circumstances, however, exercise cessation may not be solely attributable to these players: the central nervous system is thought to hold a relevant role as the ultimate site of exercise termination. In fact, there has been a growing interest relative to the “brain” response to exercise in chronic cardiorespiratory diseases, and its potential implication in limiting the tolerance to physical exertion in patients. To reach these overarching goals, non-invasive techniques, such as near-infrared spectroscopy and transcranial magnetic stimulation, have been successfully applied to get insights into the underlying mechanisms of exercise limitation in clinical populations. This review provides an up-to-date outline of the rationale for the “brain” as the organ limiting the tolerance to physical exertion in patients with cardiorespiratory diseases. We first outline some key methodological aspects of neuromuscular function and cerebral hemodynamics assessment in response to different exercise paradigms. We then review the most prominent studies, which explored the influence of major cardiorespiratory diseases on these outcomes. After a balanced summary of existing evidence, we finalize by detailing the rationale for investigating the “brain” contribution to exercise limitation in hitherto unexplored cardiorespiratory diseases, an endeavor that might lead to innovative lines of applied physiological research.
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Affiliation(s)
- Mathieu Marillier
- Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, ON, Canada
- HP2 Laboratory, INSERM U1300, Grenoble Alpes University, Grenoble, France
| | - Mathieu Gruet
- IAPS Laboratory, University of Toulon, Toulon, France
| | - Anne-Catherine Bernard
- Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, ON, Canada
- HP2 Laboratory, INSERM U1300, Grenoble Alpes University, Grenoble, France
| | - Samuel Verges
- HP2 Laboratory, INSERM U1300, Grenoble Alpes University, Grenoble, France
| | - J Alberto Neder
- Laboratory of Clinical Exercise Physiology, Queen's University and Kingston General Hospital, Kingston, ON, Canada
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12
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Song P, Holmes M, Mackensen GB. Cardiac Surgery. Perioper Med (Lond) 2022. [DOI: 10.1016/b978-0-323-56724-4.00031-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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13
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Hashem M, Wu Y, Dunn JF. Quantification of cytochrome c oxidase and tissue oxygenation using CW-NIRS in a mouse cerebral cortex. BIOMEDICAL OPTICS EXPRESS 2021; 12:7632-7656. [PMID: 35003857 PMCID: PMC8713667 DOI: 10.1364/boe.435532] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/06/2021] [Accepted: 11/05/2021] [Indexed: 05/05/2023]
Abstract
We provide a protocol for measuring the absolute concentration of the oxidized and reduced state of cytochrome c oxidase (CCO) in the cerebral cortex of mice, using broadband continuous-wave NIRS. The algorithm (NIR-AQUA) allows for absolute quantification of CCO and deoxyhemoglobin. Combined with an anoxia pulse, this also allows for quantification of total hemoglobin, and tissue oxygen saturation. CCO in the cortex was 4.9 ± 0.1 μM (mean ± SD, n=6). In normoxia, 84% of CCO was oxidized. We include hypoxia and cyanide validation studies to show CCO can be quantified independently to hemoglobin. This can be applied to study oxidative metabolism in the many rodent models of neurological disease.
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Affiliation(s)
- Mada Hashem
- Biomedical Engineering Graduate Program, University of Calgary, Calgary, Alberta, Canada T2N 4N1, Canada
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1, Canada
- Hotchkiss Brain Institute, University of Calgary, Alberta, Canada T2N 4N1, Canada
- Experimental Imaging Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada T2N 4N1, Canada
| | - Ying Wu
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1, Canada
- Hotchkiss Brain Institute, University of Calgary, Alberta, Canada T2N 4N1, Canada
- Experimental Imaging Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada T2N 4N1, Canada
| | - Jeff F. Dunn
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada T2N 4N1, Canada
- Hotchkiss Brain Institute, University of Calgary, Alberta, Canada T2N 4N1, Canada
- Experimental Imaging Centre, Cumming School of Medicine, University of Calgary, Alberta, Canada T2N 4N1, Canada
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14
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Larson S, Anderson L, Thomson S. Effect of phenylephrine on cerebral oxygen saturation and cardiac output in adults when used to treat intraoperative hypotension: a systematic review. JBI Evid Synth 2021; 19:34-58. [PMID: 32941358 DOI: 10.11124/jbisrir-d-19-00352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVE The objective of this review was to examine the effect of phenylephrine on cerebral oxygen saturation, cardiac output, and middle cerebral artery blood flow velocity when used to treat intraoperative hypotension. INTRODUCTION While the etiology of postoperative cognitive dysfunction in adults following surgery is likely multifactorial, intraoperative cerebral hypoperfusion is a commonly proposed mechanism. Research evidence and expert opinion are emerging that suggest phenylephrine adversely affects cerebral oxygen saturation and may also adversely affect cerebral perfusion via a reduction in cardiac output or cerebral vascular vasoconstriction. The administration of phenylephrine to treat intraoperative hypotension is common anesthesia practice, despite a lack of evidence to show it improves cerebral perfusion. Therefore, a systematic review of the effect of phenylephrine on cerebral hemodynamics has significant implications for anesthesia practice and future research. INCLUSION CRITERIA Studies of adults 18 years and over undergoing elective, non-neurosurgical procedures involving anesthesia were included. In these studies, participants received phenylephrine to treat intraoperative hypotension. The effect of phenylephrine on cerebral oxygen saturation, cardiac output, or middle cerebral artery blood flow velocity was measured. METHODS Key information sources searched included MEDLINE (Ovid), Embase, CINAHL (EBSCO), and Google Scholar. The scope of the search was limited to English-language studies published from 1999 through 2017. The recommended JBI approach to critical appraisal, study selection, data extraction, and data synthesis were used. RESULTS This systematic review found that phenylephrine consistently decreased cerebral oxygen saturation values despite simultaneously increasing mean arterial pressure to normal range. Results also found that ephedrine and dopamine were superior to phenylephrine in maintaining or increasing values. Phenylephrine was found to be similar to vasopressin in the extent to which both decreased cerebral oxygen saturation values. Results also showed that phenylephrine resulted in statistically significant declines in cardiac output, or failed to improve abnormally low preintervention values. The effect of phenylephrine on middle cerebral artery blood flow velocity was only measured in one study and showed that phenylephrine increased flow velocity by about 20%. Statistical pooling of the study results was not possible due to the gross variation in how the intervention was administered and how effect was measured. CONCLUSIONS This review found that phenylephrine administration resulted in declines in cerebral oxygen saturation and cardiac output. However, the research studies were ineffective in informing phenylephrine's mechanism of action or its impact on postoperative cognitive function. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO (CRD42018100740).
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Affiliation(s)
- Sandra Larson
- Rosalind Franklin University of Medicine and Science: A JBI Affiliated Group, Chicago, IL, USA
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15
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Dipla K, Boutou AK, Markopoulou A, Pitsiou G, Papadopoulos S, Chatzikosti A, Stanopoulos I, Zafeiridis A. Exertional Desaturation in Idiopathic Pulmonary Fibrosis: The Role of Oxygen Supplementation in Modifying Cerebral-Skeletal Muscle Oxygenation and Systemic Hemodynamics. Respiration 2021; 100:463-475. [PMID: 33784706 DOI: 10.1159/000514320] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In patients with idiopathic pulmonary fibrosis (IPF) with isolated exertional desaturation, there are limited data regarding the effectiveness of oxygen supplementation during exercise training; the underlying mechanisms that contribute to these responses are unknown. OBJECTIVES To examine in these IPF patients the effects of oxygen supplementation during submaximal exercise (vs. medical air) on cerebral/skeletal muscle oxygenation and systemic hemodynamics. METHODS In this randomized, cross-over, placebo-controlled trial, IPF patients (n = 13; 63.4 ± 9.6 years) without resting hypoxemia but a significant desaturation during maximal cardiopulmonary exercise testing underwent 2 steady-state exercise trials (65% peak-work-load), breathing either oxygen-enriched or medical air. Cerebral/skeletal muscle oxygenation (near-infrared spectroscopy) and beat-by-beat hemodynamics (photoplethysmography) were monitored. RESULTS In the air protocol, from the initial minutes of submaximal exercise, patients exhibited a marked decline in cerebral oxygenated hemoglobin (O2Hb) and an abrupt rise in deoxygenated hemoglobin (HHb). Oxygen supplementation alleviated desaturation, lessened dyspnea, and prolonged exercise duration (p < 0.01). Oxygen supplementation during exercise (i) attenuated cerebral deoxygenation (cerebral-HHb: 0.7 ± 1.9 vs. 2.5 ± 1.5 μmol/L, O2 and air protocol; p = 0.009) and prevented cerebral-Hbdifference decline (2.1 ± 2.7 vs. -1.7 ± 2.0 μmol/L; p = 0.001), (ii) lessened the decline in muscle O2-saturation index, and (iii) at isotime exercise, it resulted in lower muscle-HHb (p = 0.05) and less leg fatigue (p < 0.05). No differences between protocols were observed in exercise cardiac output and vascular resistance. CONCLUSIONS IPF patients with isolated exertional hypoxemia exhibit an inability to increase/maintain cerebral oxygenation during submaximal exercise. Correcting desaturation with O2 supplementation prevented the decline in brain oxygenation, improved muscle oxygenation, and lessened dyspnea, suggesting an efficacy of acute oxygen supplementation during exercise training in protecting brain hypoxia in these IPF patients.
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Affiliation(s)
- Konstantina Dipla
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Afroditi K Boutou
- Department of Respiratory Medicine, "G. Papanikolaou" Hospital, Thessaloniki, Greece
| | | | - Georgia Pitsiou
- Department of Respiratory Failure, "G. Papanikolaou" Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stavros Papadopoulos
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Anastasia Chatzikosti
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Ioannis Stanopoulos
- Department of Respiratory Failure, "G. Papanikolaou" Hospital, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Zafeiridis
- Exercise Physiology & Biochemistry Laboratory, Department of Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
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16
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Almajidy RK, Mankodiya K, Abtahi M, Hofmann UG. A Newcomer's Guide to Functional Near Infrared Spectroscopy Experiments. IEEE Rev Biomed Eng 2019; 13:292-308. [PMID: 31634142 DOI: 10.1109/rbme.2019.2944351] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This review presents a practical primer for functional near-infrared spectroscopy (fNIRS) with respect to technology, experimentation, and analysis software. Its purpose is to jump-start interested practitioners considering utilizing a non-invasive, versatile, nevertheless challenging window into the brain using optical methods. We briefly recapitulate relevant anatomical and optical foundations and give a short historical overview. We describe competing types of illumination (trans-illumination, reflectance, and differential reflectance) and data collection methods (continuous wave, time domain and frequency domain). Basic components (light sources, detection, and recording components) of fNIRS systems are presented. Advantages and limitations of fNIRS techniques are offered, followed by a list of very practical recommendations for its use. A variety of experimental and clinical studies with fNIRS are sampled, shedding light on many brain-related ailments. Finally, we describe and discuss a number of freely available analysis and presentation packages suited for data analysis. In conclusion, we recommend fNIRS due to its ever-growing body of clinical applications, state-of-the-art neuroimaging technique and manageable hardware requirements. It can be safely concluded that fNIRS adds a new arrow to the quiver of neuro-medical examinations due to both its great versatility and limited costs.
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17
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Vanpeteghem CM, Van de Moortel LMM, De Hert SG, Moerman AT. Assessment of Spinal Cord Ischemia With Near-Infrared Spectroscopy: Myth or Reality? J Cardiothorac Vasc Anesth 2019; 34:791-796. [PMID: 31399303 DOI: 10.1053/j.jvca.2019.06.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 06/21/2019] [Accepted: 06/27/2019] [Indexed: 11/11/2022]
Abstract
Non-invasive near-infrared spectroscopy is gaining popularity in the detection of spinal cord ischemia following aortic aneurysm repair. However, practical recommendations are lacking. This review focuses on the physiological and anatomical background, as well as on the clinical implementations of near-infrared spectroscopy as a tool for monitoring ischemia of the spinal cord. Clinical recommendations based on the currently available evidence are rendered.
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Affiliation(s)
- C M Vanpeteghem
- Department of Anesthesia and Perioperative Care, University Hospital Ghent, Ghent, Belgium.
| | - L M M Van de Moortel
- Department of Anesthesia and Perioperative Care, University Hospital Ghent, Ghent, Belgium
| | - S G De Hert
- Department of Anesthesia and Perioperative Care, University Hospital Ghent, Ghent, Belgium
| | - A T Moerman
- Department of Anesthesia and Perioperative Care, University Hospital Ghent, Ghent, Belgium
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18
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Ni C, Wang D, Tao Y. Variable weighted convolutional neural network for the nitrogen content quantization of Masson pine seedling leaves with near-infrared spectroscopy. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2019; 209:32-39. [PMID: 30343107 DOI: 10.1016/j.saa.2018.10.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/14/2018] [Indexed: 06/08/2023]
Abstract
Spectroscopy is a powerful non-destructive quantization tool. In this paper, the technology is used to predict the nitrogen content of Masson pine seedling leaves. Masson pine is widely planted in China, and its nitrogen content is an important index for evaluating the vigour of seedings. To establish a better prediction model, an improved 1D convolutional neural network architecture, named the variable weighted convolutional neural network (VWCNN), is proposed in this research. The new model can automatically force the network attention onto the important spectrum wavelengths and is able to improve the generalization ability of the basic 1D-CNN model. For 219 fresh Masson pine seedling leaves, it shows better results in the prediction accuracy and robustness compared to those derived from the traditional shallow prediction model and other CNN-based models. VWCNN can achieve a 0.984 R2 and 0.038 RMSE value in training dataset and 0.925 R2 value and 0.075 RMSE value in the test dataset. The proposed model was also tested on a public corn kernel dataset. For the dataset output, moisture, oil, protein, and starch, the new model also achieves state-of-the-art prediction results.
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Affiliation(s)
- Chao Ni
- College of Mechanical and Electronic Engineering, Nanjing Forestry University, Nanjing 210037, PR China; Bio-Imaging and Machine Vision Lab, Fischell Department of Bioengineering, University of Maryland, College Park 20740, USA
| | - Dongyi Wang
- Bio-Imaging and Machine Vision Lab, Fischell Department of Bioengineering, University of Maryland, College Park 20740, USA.
| | - Yang Tao
- Bio-Imaging and Machine Vision Lab, Fischell Department of Bioengineering, University of Maryland, College Park 20740, USA.
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19
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Govindan RB, Massaro AN, du Plessis A. Ensuring signal quality of cerebral near infrared spectroscopy during continuous longterm monitoring. J Neurosci Methods 2018; 309:147-152. [PMID: 30189283 PMCID: PMC6323003 DOI: 10.1016/j.jneumeth.2018.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/18/2018] [Accepted: 09/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Near infrared spectroscopy (NIRS) derived hemoglobin difference (HbD: oxygenated [HbO2] - reduced hemoglobin [Hb]) and total hemoglobin (HbT: HbO2+Hb) have been used as surrogate measures of cerebral blood flow and volume, respectively. Statistically, a lack of HbD-blood pressure (BP) or negative HbT-BP association is regarded as a state of intact cerebral pressure autoregulation (CPA). In contrast, a co-variation of HbD/HbT and systemic blood pressure (BP) in the same direction is thought of as a failure of CPA. If the quality of one (NIRS/BP) or both signals is compromised, the reliability of the results may be adversely affected. In this work, we develop an analytic approach to assess the quality of the NIRS signals. NEW METHOD Given that cardiac pulses cause hemodynamic changes that are transmitted through the peripheral vasculature, cerebral NIRS signals should exhibit cyclical changes at the pulse frequency. Therefore, we propose that an association between HbD/HbT and electrocardiogram (EKG) signals would be an indicator of NIRS quality. We demonstrate the application of this approach with data collected from six newborns undergoing therapeutic hypothermia for neonatal encephalopathy. RESULTS We observed an intermittent lack of association between NIRS signals and EKG data over the course of several hours of continuous records, indicating a loss in the strength in NIRS signals. COMPARISON WITH EXISTING METHOD Existing CPA characterization suffers from Type-II error which the current preprocessing approach can mitigate. CONCLUSIONS The proposed approach will allow for real-time assessment of NIRS signal quality that is essential for accurate CPA monitoring.
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Affiliation(s)
- R B Govindan
- Division of Fetal and Transitional Medicine, Children's National Health System, 111 Michigan Ave, NW, Washington, DC', 20010, USA.
| | - A N Massaro
- Division of Fetal and Transitional Medicine, Children's National Health System, 111 Michigan Ave, NW, Washington, DC', 20010, USA; Division of Neonatology, Children's National Health System, 111 Michigan Ave, NW, Washington, DC, 20010, USA
| | - Adre du Plessis
- Division of Fetal and Transitional Medicine, Children's National Health System, 111 Michigan Ave, NW, Washington, DC', 20010, USA
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20
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Larson SL, Anderson LR, Thomson JS. The effect of phenylephrine on cerebral perfusion when used to treat anesthesia-induced hypotension: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2018; 16:1346-1353. [PMID: 29894402 DOI: 10.11124/jbisrir-2017-003426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
REVIEW QUESTION The question of this review is: What is the effect of intravenous phenylephrine on cerebral perfusion in adult patients when administered to treat anesthesia-induced hypotension?
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Affiliation(s)
- Sandra Louise Larson
- Rosalind Franklin University of Medicine and Science: a Joanna Briggs Institute Affiliated Group, Chicago, USA
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21
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Tang R, Chen X, Li C. Detection of Nitrogen Content in Rubber Leaves Using Near-Infrared (NIR) Spectroscopy with Correlation-Based Successive Projections Algorithm (SPA). APPLIED SPECTROSCOPY 2018; 72:740-749. [PMID: 29617151 DOI: 10.1177/0003702818755142] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Near-infrared spectroscopy is an efficient, low-cost technology that has potential as an accurate method in detecting the nitrogen content of natural rubber leaves. Successive projections algorithm (SPA) is a widely used variable selection method for multivariate calibration, which uses projection operations to select a variable subset with minimum multi-collinearity. However, due to the fluctuation of correlation between variables, high collinearity may still exist in non-adjacent variables of subset obtained by basic SPA. Based on analysis to the correlation matrix of the spectra data, this paper proposed a correlation-based SPA (CB-SPA) to apply the successive projections algorithm in regions with consistent correlation. The result shows that CB-SPA can select variable subsets with more valuable variables and less multi-collinearity. Meanwhile, models established by the CB-SPA subset outperform basic SPA subsets in predicting nitrogen content in terms of both cross-validation and external prediction. Moreover, CB-SPA is assured to be more efficient, for the time cost in its selection procedure is one-twelfth that of the basic SPA.
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Affiliation(s)
- Rongnian Tang
- School of Mechanical and Electrical Engineering, Hainan University, Haikou, China
| | - Xupeng Chen
- School of Mechanical and Electrical Engineering, Hainan University, Haikou, China
| | - Chuang Li
- School of Mechanical and Electrical Engineering, Hainan University, Haikou, China
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22
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Chen YJ, Wang JS, Hsu CC, Lin PJ, Tsai FC, Wen MS, Kuo CT, Huang SC. Cerebral desaturation in heart failure: Potential prognostic value and physiologic basis. PLoS One 2018; 13:e0196299. [PMID: 29689105 PMCID: PMC5916527 DOI: 10.1371/journal.pone.0196299] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 04/10/2018] [Indexed: 01/01/2023] Open
Abstract
Cerebral tissue oxygen saturation (SctO2) reflects cerebral perfusion and tissue oxygen consumption, which decline in some patients with heart failure with reduced ejection fraction (HFrEF) or stroke, especially during exercise. Its physiologic basis and clinical significance remain unclear. We aimed to investigate the association of SctO2 with oxygen transport physiology and known prognostic factors during both rest and exercise in patients with HFrEF or stroke. Thirty-four HFrEF patients, 26 stroke patients, and 17 healthy controls performed an incremental cardiopulmonary exercise test using a bicycle ergometer. Integrated near-infrared spectroscopy and automatic gas analysis were used to measure cerebral tissue oxygenation and cardiac and ventilatory parameters. We found that SctO2 (rest; peak) were significantly lower in the HFrEF (66.3±13.3%; 63.4±13.8%,) than in the stroke (72.1±4.2%; 72.7±4.5%) and control (73.1±2.8%; 72±3.2%) groups. In the HFrEF group, SctO2 at rest (SctO2rest) and peak SctO2 (SctO2peak) were linearly correlated with brain natriuretic peptide (BNP), peak oxygen consumption ( V˙O2peak), and oxygen uptake efficiency slope (r between -0.561 and 0.677, p < 0.001). Stepwise linear regression showed that SctO2rest was determined by partial pressure of end-tidal carbon dioxide at rest (PETCO2rest), hemoglobin, and mean arterial pressure at rest (MAPrest) (adjusted R = 0.681, p < 0.05), while SctO2peak was mainly affected by peak carbon dioxide production ( V˙CO2peak) (adjusted R = 0.653, p < 0.05) in patients with HFrEF. In conclusion, the study delineates the relationship of cerebral saturation and parameters associated with oxygen delivery. Moreover, SctO2peak and SctO2rest are correlated with some well-recognized prognostic factors in HFrEF, suggesting its potential prognostic value.
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Affiliation(s)
- Yu-Jen Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Jong-Shyan Wang
- Healthy Aging Research Center, Graduate Institute of Rehabilitation Science, Medical College, Chang Gung University, Taoyuan, Taiwan
| | - Chih-Chin Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Pyng-Jing Lin
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Feng-Chun Tsai
- Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Ming-Shien Wen
- Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chi-Tai Kuo
- Cardiovascular Division, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shu-Chun Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Taiwan
- * E-mail:
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23
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Semrau JS, Scott SH, Hamilton AG, Petsikas D, Payne DM, Bisleri G, Saha T, Boyd JG. The relationship between cerebral oxygen saturation and quantitative metrics of neurological function after coronary bypass surgery: a feasibility study. THE JOURNAL OF CARDIOVASCULAR SURGERY 2018; 59:716-728. [PMID: 29616521 DOI: 10.23736/s0021-9509.18.10280-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND It is well-known that patients undergoing coronary artery bypass grafting (CABG) surgery may experience neurological dysfunction following their operation. However, the nature of this dysfunction has not been properly quantified. Furthermore, the relationship between postoperative impairment and cerebral oxygen saturation during surgery has remained unclear. This study aims to define the feasibility of using robotic technology to quantify post-CABG neurocognitive function, and to correlate these objective metrics with intraoperative cerebral oxygenation. METHODS Neurological function was tested using robotic technology and a standardized questionnaire before and 3 months after surgery. In addition, frontal lobe cerebral oxygenation was recorded using the FORESIGHT near-infrared spectrometer for the duration of the operation. Pre- and postoperative neurological assessment was performed for 24 participants. Of those 24, 20 participants had cerebral oxygenation recorded during their surgery. RESULTS The cerebral oximeter captured 97.2% of the data. Majority of patients experienced no significant decline in overall neurocognitive function. Abnormal postoperative scores were most frequent in a sensorimotor task that involved additional cognitive load. In this reverse visually guided reaching task, postoperative scores significantly correlated with mean and minimum intraoperative cerebral oxygenation values, with lower values being associated with worse performance. CONCLUSIONS It is feasible to use robotic technology as a quantitative and objective neurocognitive assessment method for patients undergoing CABG. The relationship between quantitative metrics of neurocognitive function and intraoperative cerebral oxygenation warrants further investigation.
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Affiliation(s)
- Joanna S Semrau
- Center for Neuroscience Studies, Queen's University, Kingston, Canada
| | - Stephen H Scott
- Center for Neuroscience Studies, Queen's University, Kingston, Canada.,Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Canada
| | - Andrew G Hamilton
- Kingston General Hospital, Kingston, Canada.,Department of Surgery, Queen's University, Kingston, Canada
| | - Dimitri Petsikas
- Kingston General Hospital, Kingston, Canada.,Department of Surgery, Queen's University, Kingston, Canada
| | - Darrin M Payne
- Kingston General Hospital, Kingston, Canada.,Department of Surgery, Queen's University, Kingston, Canada
| | - Gianluigi Bisleri
- Kingston General Hospital, Kingston, Canada.,Department of Surgery, Queen's University, Kingston, Canada
| | - Tarit Saha
- Kingston General Hospital, Kingston, Canada.,Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Canada
| | - John G Boyd
- Center for Neuroscience Studies, Queen's University, Kingston, Canada - .,Kingston General Hospital, Kingston, Canada.,Department of Critical Care (Neurology), Queen's University, Kingston, Canada
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24
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Abstract
Cerebrovascular injury while on extracorporeal membrane oxygenation (ECMO) may be caused by excessive brain perfusion during hypoxemic reperfusion. Previous studies have postulated that the most vulnerable period of time for cerebrovascular injury is during the transfer period to ECMO. Therefore, our objective was to compare brain perfusion and hemodynamics in a piglet endotoxic shock ECMO model. The effect of ECMO flow on microcirculation of different brain regions was compared between 10 control pigs and six pigs (7–10 kg) administered IV endotoxin to achieve a drop in mean arterial blood pressure (MAP) of at least 30%. Cardiac output (CO), brain oxygen utilization, and microcirculatory blood flow (BF) were compared at baseline and 2 hours after ECMO stabilization. Matching ECMO delivery with baseline CO in control animals increased perfusion (p < 0.05) in all areas of the brain. In contrast, with endotoxin, ECMO returned perfusion closer to baseline levels in all regions of the brain and maintained brain tissue oxygen consumption. Both control and endotoxic pigs showed no evidence of acute neuronal necrosis in histologic cerebral cortical sections examined after 2 hours of ECMO. Results show that during endotoxic shock, transition to ECMO can maintain brain BF equally to all brain regions without causing overperfusion, and does not appear to cause brain tissue histopathologic changes (hemorrhage or necrosis) during the acute stabilization period after ECMO induction.
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Kassab A, Le Lan J, Tremblay J, Vannasing P, Dehbozorgi M, Pouliot P, Gallagher A, Lesage F, Sawan M, Nguyen DK. Multichannel wearable fNIRS-EEG system for long-term clinical monitoring. Hum Brain Mapp 2017; 39:7-23. [PMID: 29058341 DOI: 10.1002/hbm.23849] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/02/2017] [Accepted: 10/08/2017] [Indexed: 01/27/2023] Open
Abstract
Continuous brain imaging techniques can be beneficial for the monitoring of neurological pathologies (such as epilepsy or stroke) and neuroimaging protocols involving movement. Among existing ones, functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG) have the advantage of being noninvasive, nonobstructive, inexpensive, yield portable solutions, and offer complementary monitoring of electrical and local hemodynamic activities. This article presents a novel system with 128 fNIRS channels and 32 EEG channels with the potential to cover a larger fraction of the adult superficial cortex than earlier works, is integrated with 32 EEG channels, is light and battery-powered to improve portability, and can transmit data wirelessly to an interface for real-time display of electrical and hemodynamic activities. A novel fNIRS-EEG stretchable cap, two analog channels for auxiliary data (e.g., electrocardiogram), eight digital triggers for event-related protocols and an internal accelerometer for movement artifacts removal contribute to improve data acquisition quality. The system can run continuously for 24 h. Following instrumentation validation and reliability on a solid phantom, performance was evaluated on (1) 12 healthy participants during either a visual (checkerboard) task at rest or while pedalling on a stationary bicycle or a cognitive (language) task and (2) 4 patients admitted either to the epilepsy (n = 3) or stroke (n = 1) units. Data analysis confirmed expected hemodynamic variations during validation recordings and useful clinical information during in-hospital testing. To the best of our knowledge, this is the first demonstration of a wearable wireless multichannel fNIRS-EEG monitoring system in patients with neurological conditions. Hum Brain Mapp 39:7-23, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Ali Kassab
- Research Center, Centre Hospitalier Universitaire de Montréal, Université de Montréal, Montréal, Québec, H2X 0A9, Canada
| | - Jérôme Le Lan
- Department of Electrical Engineering, École Polytechnique de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Julie Tremblay
- Research Center, Hôpital Sainte-Justine, Université de Montréal, Montréal, Québec, H3T 1C4, Canada
| | - Phetsamone Vannasing
- Research Center, Hôpital Sainte-Justine, Université de Montréal, Montréal, Québec, H3T 1C4, Canada
| | - Mahya Dehbozorgi
- Department of Electrical Engineering, École Polytechnique de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Philippe Pouliot
- Department of Electrical Engineering, École Polytechnique de Montréal, Montréal, Québec, H3T 1J4, Canada.,Research Center, Montreal Heart Institute, Montréal, Québec, H1T 1C8, Canada
| | - Anne Gallagher
- Research Center, Hôpital Sainte-Justine, Université de Montréal, Montréal, Québec, H3T 1C4, Canada
| | - Frédéric Lesage
- Department of Electrical Engineering, École Polytechnique de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Mohamad Sawan
- Department of Electrical Engineering, École Polytechnique de Montréal, Montréal, Québec, H3T 1J4, Canada
| | - Dang Khoa Nguyen
- Research Center, Centre Hospitalier Universitaire de Montréal, Université de Montréal, Montréal, Québec, H2X 0A9, Canada.,Department of Neurology, Hôpital Notre-Dame (Centre Hospitalier de l'Université de Montréal), Montréal, Québec, H2L 4M1, Canada
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Use of renal near-infrared spectroscopy measurements in congenital diaphragmatic hernia patients on ECMO. J Pediatr Surg 2017; 52:689-692. [PMID: 28190559 DOI: 10.1016/j.jpedsurg.2017.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 01/23/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study tests the hypothesis that renal tissue oxygen saturation as measured by Near Infrared Spectroscopy (NIRS) would correlate with urine output in neonates with congenital diaphragmatic hernia (CDH) on extracorporeal membrane oxygenation (ECMO). METHODS Between 2012 and 2015, neonates with CDH were enrolled as part of a comprehensive study that provided renal/cerebral/abdominal NIRS monitoring for the duration of ECMO support. Continuous NIRS measurements, mean arterial pressure, and urine output were recorded. Periods of anuria (NU), adequate urine output >1ml/kg/h (AU), and low urine output <1ml/kg/h (LU) were noted and analyzed. RESULTS Over 1500h of continuous renal NIRS were obtained from six neonates. NIRS values were significantly different during periods of AU, LU, and anuria (84±6%, 76±3%, and 67±6%, p<0.01). ROC curves identified NIRS >76% as highly predictive of adequate urine output (AUC=0.96). MAP was significantly lower only in anuric patients, 36.42±10.26, compared to patients with AU and LU - 42.99±5.25 and 42.85±7.4, respectively (p<0.001). CONCLUSION Renal NIRS measurements correlate with urine production. Lower values are noted as urine output declines and precedes a decline in MAP. Renal NIRS may have promise as a non-invasive means of determining adequacy of renal perfusion and urine output in neonates with complex fluid shifts. LEVEL OF EVIDENCE IIb.
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Benni PB, MacLeod D, Ikeda K, Lin HM. A validation method for near-infrared spectroscopy based tissue oximeters for cerebral and somatic tissue oxygen saturation measurements. J Clin Monit Comput 2017; 32:269-284. [PMID: 28374103 PMCID: PMC5838152 DOI: 10.1007/s10877-017-0015-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 03/23/2017] [Indexed: 12/19/2022]
Abstract
We describe the validation methodology for the NIRS based FORE-SIGHT ELITE® (CAS Medical Systems, Inc., Branford, CT, USA) tissue oximeter for cerebral and somatic tissue oxygen saturation (StO2) measurements for adult subjects submitted to the United States Food and Drug Administration (FDA) to obtain clearance for clinical use. This validation methodology evolved from a history of NIRS validations in the literature and FDA recommended use of Deming regression and bootstrapping statistical validation methods. For cerebral validation, forehead cerebral StO2 measurements were compared to a weighted 70:30 reference (REF CXB) of co-oximeter internal jugular venous and arterial blood saturation of healthy adult subjects during a controlled hypoxia sequence, with a sensor placed on the forehead. For somatic validation, somatic StO2 measurements were compared to a weighted 70:30 reference (REF CXS) of co-oximetry central venous and arterial saturation values following a similar protocol, with sensors place on the flank, quadriceps muscle, and calf muscle. With informed consent, 25 subjects successfully completed the cerebral validation study. The bias and precision (1 SD) of cerebral StO2 compared to REF CXB was −0.14 ± 3.07%. With informed consent, 24 subjects successfully completed the somatic validation study. The bias and precision of somatic StO2 compared to REF CXS was 0.04 ± 4.22% from the average of flank, quadriceps, and calf StO2 measurements to best represent the global whole body REF CXS. The NIRS validation methods presented potentially provide a reliable means to test NIRS monitors and qualify them for clinical use.
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Affiliation(s)
- Paul B Benni
- CAS Medical Systems (CASMED), Inc., Branford, CT, USA.
| | - David MacLeod
- Human Pharmacology & Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Keita Ikeda
- Human Pharmacology & Physiology Lab, Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA
| | - Hung-Mo Lin
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Mebius MJ, du Marchie Sarvaas GJ, Wolthuis DW, Bartelds B, Kneyber MCJ, Bos AF, Kooi EMW. Near-infrared spectroscopy as a predictor of clinical deterioration: a case report of two infants with duct-dependent congenital heart disease. BMC Pediatr 2017; 17:79. [PMID: 28302079 PMCID: PMC5356300 DOI: 10.1186/s12887-017-0839-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 03/11/2017] [Indexed: 11/12/2022] Open
Abstract
Background Some infants with congenital heart disease are at risk of in-hospital cardiac arrest. To better foresee cardiac arrest in infants with congenital heart disease, it might be useful to continuously assess end-organ perfusion. Near-infrared spectroscopy is a non-invasive method to continuously assess multisite regional tissue oxygen saturation. Case presentation We report on two infants with duct-dependent congenital heart disease who demonstrated a gradual change in cerebral and/or renal tissue oxygen saturation before cardiopulmonary resuscitation was required. In both cases, other clinical parameters such as heart rate, arterial oxygen saturation and blood pressure did not indicate that deterioration was imminent. Conclusions These two cases demonstrate that near-infrared spectroscopy might contribute to detecting a deteriorating clinical condition and might therefore be helpful in averting cardiopulmonary collapse and need for resuscitation in infants with congenital heart disease.
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Affiliation(s)
- Mirthe J Mebius
- University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Gideon J du Marchie Sarvaas
- University Medical Center Groningen, Center for Congenital Heart Diseases, Pediatric Cardiology, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands
| | - Diana W Wolthuis
- University Medical Center Groningen, Beatrix Children's Hospital, Division of Pediatric Intensive Care, University of Groningen, Groningen, The Netherlands
| | - Beatrijs Bartelds
- University Medical Center Groningen, Center for Congenital Heart Diseases, Pediatric Cardiology, Beatrix Children's Hospital, University of Groningen, Groningen, The Netherlands
| | - Martin C J Kneyber
- University Medical Center Groningen, Beatrix Children's Hospital, Division of Pediatric Intensive Care, University of Groningen, Groningen, The Netherlands.,Critical Care, Anesthesiology, Peri-operative & Emergency medicine (CAPE), the University of Groningen, Groningen, The Netherlands
| | - Arend F Bos
- University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Elisabeth M W Kooi
- University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
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van der Laan ME, Mebius MJ, Roofthooft MTR, Bos AF, Berger RMF, Kooi EMW. Cerebral and Renal Oxygen Saturation Are Not Compromised in the Presence of Retrograde Blood Flow in either the Ascending or Descending Aorta in Term or Near-Term Infants with Left-Sided Obstructive Lesions. Neonatology 2017; 112:217-224. [PMID: 28704832 DOI: 10.1159/000473870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 03/30/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND In infants with left-sided obstructive lesions (LSOL), the presence of retrograde blood flow in either the ascending or descending aorta may lead to diminished cerebral and renal blood flow, respectively. OBJECTIVES Our aim was to compare cerebral and renal tissue oxygen saturation (rSO2) between infants with LSOL with antegrade and retrograde blood flow in the ascending aorta and with and without diastolic backflow in the descending aorta. METHODS Based on 2 echocardiograms, the study group was categorized according to the direction of blood flow in the ascending and descending aorta. We measured cerebral and renal rSO2 using near-infrared spectroscopy and calculated fractional tissue oxygen extraction (FTOE). RESULTS Nineteen infants with LSOL, admitted to the NICU between 0 and 28 days after birth, were included. Infants with antegrade blood flow (n = 12) and infants with retrograde blood flow in the ascending aorta (n = 7) had similar cerebral rSO2 and FTOE during both echocardiograms. Only during the first echocardiogram, infants with retrograde blood flow in the ascending aorta had lower renal FTOE (0.14 vs. 0.32, p = 0.04) and tended to have higher renal rSO2 (80 vs. 65%, p = 0.09). The presence of diastolic backflow in the descending aorta was not associated with cerebral or renal rSO2 and FTOE during the first (n = 8) as well as the second echocardiogram (n = 10). CONCLUSIONS Retrograde blood flow in the ascending aorta was not associated with cerebral oxygenation, while diastolic backflow in the descending aorta was not associated with renal oxygenation in infants with LSOL.
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Affiliation(s)
- Michelle E van der Laan
- Division of Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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30
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Abstract
Useful resuscitation endpoints must serve both to diagnose the need for and to ensure the ongoing adequacy of resuscitation. To this end, traditional measures of organ perfusion are now widely appreciated to be grossly inadequate. Useful endpoints or milestones range from the global, to the regional, to the cellular specific. Understanding the basic principles of perfusion-related dysoxia in trauma and hemorrhage and its potential rapid transition to involve inflammatory and immune responses on cellular oxygen utilization will aid the clinician in choosing and appropriately interpreting endpoint monitoring data. There also appears to be an optimal window of opportunity for monitoring to help mitigate the development of more complicated inflammatory states. This article reviews the underlying need for endpoint selection (both global and regional, biochemical and functional) and monitoring during resuscitation of the polytrauma patient. At this juncture it appears that early use of a blend of global markers such as lactate and base deficit coupled with an available sensitive regional monitor such as gastric tonometry may offer the best combination of current technology to guard against early perfusion-related dysoxia. Future techniques involving optical spectroscopy offer the exciting potential to assess oxygenation at the cellular level. This may aid in ultra-early detection and resolution of perfusion-related dysoxia in addition to recognizing its transition to more complex inflammatory-mediated circulatory and metabolic failure.
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Affiliation(s)
- Kevin R. Ward
- Virginia Commonwealth University Reanimation Engineering and Shock Center (VCURES), Richmond, VA., Departments of Emergency Medicine and Physiology, Virginia Commonwealth University, Richmond, VA., Department of Surgery and Section of Trauma and Surgical Critical Care, Virginia Commonwealth University, Richmond, VA
| | - Rao R. Ivatury
- Virginia Commonwealth University Reanimation Engineering and Shock Center (VCURES), Richmond, VA., Departments of Emergency Medicine and Physiology, Virginia Commonwealth University, Richmond, VA., Department of Surgery and Section of Trauma and Surgical Critical Care, Virginia Commonwealth University, Richmond, VA
| | - R. Wayne Barbee
- Virginia Commonwealth University Reanimation Engineering and Shock Center (VCURES), Richmond, VA., Departments of Emergency Medicine and Physiology, Virginia Commonwealth University, Richmond, VA
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Mebius MJ, van der Laan ME, Verhagen EA, Roofthooft MT, Bos AF, Kooi EM. Cerebral oxygen saturation during the first 72h after birth in infants diagnosed prenatally with congenital heart disease. Early Hum Dev 2016; 103:199-203. [PMID: 27741476 DOI: 10.1016/j.earlhumdev.2016.10.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 10/03/2016] [Accepted: 10/03/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Evidence suggests that hypoxic-ischemic brain injury in infants with congenital heart disease already occurs during early life. The aim of our study was, therefore, to assess the course of regional cerebral oxygen saturation (rcSO2) and fractional tissue oxygen extraction (FTOE) during the first 72h after birth in infants with prenatally diagnosed duct-dependent congenital heart disease. In addition, we identified clinical parameters that were associated with rcSO2. MATERIALS AND METHODS We included 56 infants with duct-dependent congenital heart disease. We measured arterial oxygen saturation (SpO2) and rcSO2 during the first 72h after birth. Simultaneously, we calculated FTOE. RESULTS We observed median rcSO2 values of approximately 60%, a decreasing FTOE from 0.34 on day 1 to 0.28 on day 3 and stable preductal SpO2 values around 90%. Several clinical variables were associated with rcSO2. In a multiple linear regression model only type of CHD and preductal SpO2 were significant predictors of rcSO2 during the first three days after birth. Infants with a duct-dependent pulmonary circulation had up to 12% lower rcSO2 values than infants with a duct-dependent systemic circulation. CONCLUSION We demonstrated that, during the first three days after birth, cerebral oxygen saturation is low in infants with duct-dependent congenital heart disease. Furthermore, this study provides preoperative reference values of rcSO2 and FTOE in infants with duct-dependent CHD.
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Affiliation(s)
- Mirthe J Mebius
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Groningen, The Netherlands.
| | - Michelle E van der Laan
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Groningen, The Netherlands
| | - Elise A Verhagen
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Groningen, The Netherlands
| | - Marcus Tr Roofthooft
- University of Groningen, University Medical Center Groningen, Center for Congenital Heart Diseases, Pediatric Cardiology, Beatrix Children's Hospital, Groningen, The Netherlands
| | - Arend F Bos
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Groningen, The Netherlands
| | - Elisabeth Mw Kooi
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Division of Neonatology, Groningen, The Netherlands
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Addison PS. Identifying stable phase coupling associated with cerebral autoregulation using the synchrosqueezed cross-wavelet transform and low oscillation morlet wavelets. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:5960-3. [PMID: 26737649 DOI: 10.1109/embc.2015.7319749] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A novel method of identifying stable phase coupling behavior of two signals within the wavelet transform time-frequency plane is presented. The technique employs the cross-wavelet transform to provide a map of phase coupling followed by synchrosqueezing to collect the stable phase regime information. The resulting synchrosqueezed cross-wavelet transform method (Synchro-CrWT) is illustrated using a synthetic signal and then applied to the analysis of the relationship between biosignals used in the analysis of cerebral autoregulation function.
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Van de Velde S, Kalmar AF, Raes M, Poelaert J, Lootens T, Vanoverschelde H. Lower Extremity Near-infrared Spectroscopy After Popliteal Block For Orthopaedic Foot Surgery. Open Orthop J 2016; 10:258-63. [PMID: 27563364 PMCID: PMC4962434 DOI: 10.2174/1874325001610010258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 05/18/2016] [Accepted: 05/31/2016] [Indexed: 11/22/2022] Open
Abstract
Background: Noninvasive measurement of cutaneous tissue oxygenation using near-infrared spectroscopy (NIRS) has become common in peri-operative care. Following institution of peripheral nerve blocks, neurovascular alterations in the blocked region have been described. Objective: The primary aim of this study encompassed the assessment of the influence of a popliteal block on changes in regional oxygen saturation (SrO2), and the location of most prominent changes. Method: We conducted a prospective randomised controlled trial. Hundred twenty patients who received a popliteal block for foot surgery were included. Popliteal block was performed under echographic guidance. The patients were randomized in 3 groups according to the location of the SrO2 electrodes on the legs. Bilateral SrO2 measurements were performed simultaneously. SrO2 in the operated leg and in the control leg was measured at baseline and 1, 5, 10, 15, and 30 minutes after the perineural injection. We quantified the evolution in SrO2 by calculating over time the differences in SrO2 values between the operated and control leg (=ΔSrO2). Results: At 30 minutes, ΔSrO2 increased significantly (p<0.05) at the plantar side of the foot (11.3% ± 2.9%), above the ankle (4.9% ± 1.3%) and the popliteal fossa (3.6% ± 1.2%). Conclusion: At 30 minutes after institution of the popliteal block, ΔSrO2 was most prominent at the plantar side of the foot as compared with measurement performed above the ankle or under the knee.
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Affiliation(s)
- Stijn Van de Velde
- Department of Anesthesia and Critical Care Medicine, Maria Middelares Hospital, Ghent, Belgium
| | - Alain F Kalmar
- Department of Anesthesia and Critical Care Medicine, Maria Middelares Hospital, Ghent, Belgium
| | - Matthias Raes
- Department of Anesthesia and Critical Care Medicine, Maria Middelares Hospital, Ghent, Belgium
| | - Jan Poelaert
- Department of Anesthesiology and Perioperative Medicine, Acute and Chronic Pain Therapy, University Hospital, Brussels, Belgium
| | - Tom Lootens
- Department of Orthopaedic Surgery and Traumatology, Maria Middelares hospital, Ghent, Belgium
| | - Henk Vanoverschelde
- Department of Anesthesia and Critical Care Medicine, Maria Middelares Hospital, Ghent, Belgium
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Lal C, Leahy MJ. An Updated Review of Methods and Advancements in Microvascular Blood Flow Imaging. Microcirculation 2016; 23:345-63. [DOI: 10.1111/micc.12284] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 04/17/2016] [Indexed: 12/12/2022]
Affiliation(s)
- Cerine Lal
- Department of Applied Physics; Tissue Optics and Microcirculation Imaging; National University of Ireland; Galway Ireland
| | - Martin J Leahy
- Department of Applied Physics; Tissue Optics and Microcirculation Imaging; National University of Ireland; Galway Ireland
- Royal College of Surgeons in Ireland; Dublin Ireland
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O'Brien A, LaCombe A, Stickland A, Madder RD. Intracoronary near-infrared spectroscopy: an overview of the technology, histologic validation, and clinical applications. Glob Cardiol Sci Pract 2016; 2016:e201618. [PMID: 29043266 PMCID: PMC5642785 DOI: 10.21542/gcsp.2016.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Intracoronary near-infrared spectroscopy (NIRS) imaging, which is now clinically available in a combined NIRS and intravascular ultrasound catheter, is a novel catheter-based imaging modality capable of identifying lipid core plaque within the coronary arteries of living patients. The present manuscript provides an overview of intracoronary NIRS imaging with a focus on several concepts essential to individuals seeking to better understand this novel imaging modality. One of the major assets of NIRS is that it has been rigorously validated against the gold standard of histopathology and has been shown to accurately identify histologically-proven fibroatheroma. Clinical studies of NIRS have demonstrated its ability to accurately identify large lipid core plaques at culprit lesions across the spectrum of acute coronary syndromes. NIRS has also been shown to detect lesions at increased risk of causing peri-procedural myocardial infarction during PCI. With regards to predicting future risk, NIRS is seemingly capable of identifying vulnerable patients at increased risk of experiencing subsequent patient-level cardiovascular events. In addition to these clinical applications of NIRS, there are several large prospective observational studies underway to determine if NIRS imaging will be able to identify vulnerable plaques at increased risk of triggering site-specific future coronary events. These studies, once completed, are anticipated to provide valuable data regarding the ability of NIRS imaging to identify plaque vulnerability.
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Affiliation(s)
- Andrew O'Brien
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Andrew LaCombe
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Aubrey Stickland
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
| | - Ryan D Madder
- Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA
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Green MS, Sehgal S, Tariq R. Near-Infrared Spectroscopy: The New Must Have Tool in the Intensive Care Unit? Semin Cardiothorac Vasc Anesth 2016; 20:213-24. [PMID: 27206637 DOI: 10.1177/1089253216644346] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Standard hemodynamic monitoring such as blood pressure and pulse oximetry may only provide a crude estimation of organ perfusion in the critical care setting. Near-infrared spectroscopy (NIRS) is based on the same principle as a pulse oximeter and allows continuous noninvasive monitoring of hemoglobin oxygenation and deoxygenation and thus tissue saturation "StO2" This review aims to provide an overview of NIRS technology principles and discuss its current clinical use in the critical care setting. The study selection was performed using the PubMed database to find studies that investigated the use of NIRS in both the critical care setting and in the intensive care unit. Currently, NIRS in the critical care setting is predominantly being used for infants and neonates. A number of studies in the past decade have shown promising results for the use of NIRS in surgical/trauma intensive care units during shock management as a prognostic tool and in guiding resuscitation. It is evident that over the past 2 decades, NIRS has gone from being a laboratory fascination to an actively employed clinical tool. Even though the benefit of routine use of this technology to achieve better outcomes is still questionable, the fact that NIRS is a low-cost, noninvasive monitoring modality improves the attractiveness of the technology. However, more research may be warranted before recommending its routine use in the critical care setting.
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Affiliation(s)
- Michael Stuart Green
- Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA
| | - Sankalp Sehgal
- Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA
| | - Rayhan Tariq
- Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, PA, USA
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Hemodynamic management of septic shock: is it time for "individualized goal-directed hemodynamic therapy" and for specifically targeting the microcirculation? Shock 2016; 43:522-9. [PMID: 25643016 DOI: 10.1097/shk.0000000000000345] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Septic shock is a life-threatening condition in both critically ill medical patients and surgical patients during the perioperative phase. In septic shock, specific alterations in global cardiovascular dynamics (i.e., the macrocirculation) and in the microcirculatory blood flow (i.e., the microcirculation) have been described. However, the presence and degree of microcirculatory failure are in part independent from systemic macrohemodynamic variables. Macrocirculatory and microcirculatory failure can independently induce organ dysfunction. We review current diagnostic and therapeutic approaches for the assessment and optimization of both the macrocirculation and the microcirculation in septic shock. There are various technologies for the determination of macrocirculatory hemodynamic variables. We discuss the data on early goal-directed therapy for the resuscitation of the macrocirculation. In addition, we describe the concept of "individualized goal-directed hemodynamic therapy." Technologies to assess the local microcirculation are also available. However, adequate resuscitation goals for the optimization of the microcirculation still need to be defined. At present, we are not ready to specifically monitor and target the microcirculation in clinical routine outside studies. In the future, concepts for an integrative approach for individualized hemodynamic management of the macrocirculation and in parallel the microcirculation might constitute a huge opportunity to define additional resuscitation end points in septic shock.
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Basoudan N, Shadgan B, Guenette JA, Road J, Reid WD. Effect of acute hypoxia on inspiratory muscle oxygenation during incremental inspiratory loading in healthy adults. Eur J Appl Physiol 2016; 116:841-50. [PMID: 26892509 DOI: 10.1007/s00421-016-3334-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/22/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE To non-invasively examine the effect of acute hypoxia and inspiratory threshold loading (ITL) on inspiratory muscles [sternocleidomastoid (SCM), scalene (SA) and parasternal (PS)] oxygenation in healthy adults using near-infrared spectroscopy (NIRS). METHODS Twenty healthy adults (12 M/8 F) were randomly assigned to perform two ITL tests while breathing a normoxic or hypoxic (FIO2 = 15 %) gas mixture. NIRS devices were placed over the SCM, PS, SA, and a control muscle, tibialis anterior (TA), to monitor oxygenated (O2Hb), deoxygenated (HHb), total hemoglobin (tHb) and tissue saturation index (TSI). With the nose occluded, subjects breathed normally for 4 min through a mouthpiece that was connected to a weighted threshold loading device. ITL began by adding a 100-g weight to the ITL device. Then, every 2 min 50-g was added until task failure. Vital signs, ECG and ventilatory measures were monitored throughout the protocol. RESULT Participants were 31 ± 12 year and had normal spirometry. At task failure, the maximum load and ventilatory parameters did not differ between the hypoxic and normoxic ITL. At hypoxic ITL task failure, SpO2 was significantly lower, and ∆HHb increased more so in SA, SCM and PS than normoxic values. SCM ∆TSI decreased more so during hypoxic compared to normoxic ITL. ∆tHb in the inspiratory muscles (SCM, PS and SA) increased significantly compared to the decrease in TA during both hypoxic and normoxic ITL. CONCLUSION The SCM, an accessory inspiratory muscle was the most vulnerable to deoxygenation during incremental loading and this response was accentuated by acute hypoxia.
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Affiliation(s)
- Nada Basoudan
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada.
- College of Health and Rehabilitation Sciences, Princess Nora Bint Abdul Rahman University, Riyadh, Saudi Arabia.
| | - Babak Shadgan
- International Collaboration on Repair Discoveries, Vancouver, Canada
| | - Jordan A Guenette
- Department of Physical Therapy, University of British Columbia (UBC), Vancouver, Canada
- Centre for Heart Lung Innovation, UBC and St. Paul's Hospital, Vancouver, Canada
| | - Jeremy Road
- Division of Respiratory Medicine, Department of Medicine, UBC, Vancouver, Canada
| | - W Darlene Reid
- Physical Therapy Department, University of Toronto, Toronto, Canada
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Crespi F, Cattini S, Donini M, Bandera A, Rovati L. In vivo real time non invasive monitoring of brain penetration of chemicals with near-infrared spectroscopy: Concomitant PK/PD analysis. J Neurosci Methods 2016; 258:79-86. [PMID: 26549641 DOI: 10.1016/j.jneumeth.2015.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/05/2015] [Accepted: 10/20/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Near-infrared spectroscopy (NIRS) is a non-invasive technique that monitors changes in oxygenation of haemoglobin. The absorption spectra of near-infrared light differ for the oxygenation-deoxygenation states of haemoglobin (oxygenate (HbO2) and deoxygenate (Hb), respectively) so that these two states can be directly monitored. COMPARISON WITH EXISTING METHOD(S) Different methodologies report different basal values of HbO2 and Hb absolute concentrations in brain. Here, we attempt to calculate basal HbO2 levels in rat CNS via evaluation of the influence of exogenous oxygen or exogenous carbon dioxide on the NIRS parameters measured in vivo. NEW METHOD Furthermore the possibility that changes of haemoglobin oxygenation in rat brain as measured by NIRS might be a useful index of brain penetration of chemical entities has been investigated. Different compounds from different chemical classes were selected on the basis of parallel ex vivo and in vivo pharmacokinetic (PK/PD) studies of brain penetration and overall pharmacokinetic profile. RESULTS It appeared that NIRS might contribute to assess brain penetration of chemical entities, i.e. significant changes in NIRS signals could be related to brain exposure, conversely the lack of significant changes in relevant NIRS parameters could be indicative of low brain exposure. CONCLUSIONS This work is proposing a further innovation on NIRS preclinical applications i.e. a "chemical" NIRS [chNIRS] approach for determining penetration of drugs in animal brain. Therefore, chNIRS could became a non invasive methodology for studies on neurobiological processes and psychiatric diseases in preclinical but also a translational strategy from preclinical to clinical investigations.
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Affiliation(s)
| | - Stefano Cattini
- Department of Engineering Enzo Ferrari, University of Modena and Reggio Emilia, Modena, Italy.
| | - Maurizio Donini
- Department of Engineering Enzo Ferrari, University of Modena and Reggio Emilia, Modena, Italy.
| | - Andrea Bandera
- Department of Engineering Enzo Ferrari, University of Modena and Reggio Emilia, Modena, Italy.
| | - Luigi Rovati
- Department of Engineering Enzo Ferrari, University of Modena and Reggio Emilia, Modena, Italy.
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Watanabe T, Sekine R, Mizuno T, Miwa M. Development of Portable, Wireless and Smartphone Controllable Near-Infrared Spectroscopy System. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 923:385-392. [PMID: 27526167 DOI: 10.1007/978-3-319-38810-6_50] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We have developed portable near-infrared tissue oxygenation monitoring systems, called the "PocketNIRS Duo" and the "PocketNIRS HM", which features wireless data communication and a sampling rate of up to 60 data readings per second. The systems can be controlled by smartphone or personal computer. We demonstrate the efficacy of the systems for monitoring changes in brain and arm muscle hemodynamics and oxygenation in breath-holding and cuff-occlusion tests, respectively.Our systems should prove to be useful as an oxygenation monitor not only in research but also in healthcare applications.
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Affiliation(s)
- Takashi Watanabe
- Optical Diagnostic Technology Group, Development Center, Hamamatsu Photonics K.K., Hamamatsu, Japan.
| | - Rui Sekine
- Optical Diagnostic Technology Group, Development Center, Hamamatsu Photonics K.K., Hamamatsu, Japan
| | | | - Mitsuharu Miwa
- Development Center, Hamamatsu Photonics K.K., Hamamatsu, Japan
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Espinoza Ugarte AM, Bollini C. Cirugía de hombro en posición en silla de playa: prevención de complicaciones isquémicas. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rchot.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lin BS, Wang CC, Chang MH, Chio CC. Evaluation of traumatic brain injury by optical technique. BMC Neurol 2015; 15:202. [PMID: 26467307 PMCID: PMC4606549 DOI: 10.1186/s12883-015-0465-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 10/06/2015] [Indexed: 12/27/2022] Open
Abstract
Background Traumatic brain injury (TBI), usually due to brain shaking or impact, affects the normal brain function and may lead to severe disability or even death. However, there is paucity of information regarding changes in the physiologic state of humans or animals after brain shaking. Methods In this study, near-infrared spectroscopy (NIRS) was used to continuously monitor the concentration change of oxy-hemoglobin (HbO2) and deoxy-hemoglobin (HbR) to understand changes in the physiological state during and after brain shaking. Laser Doppler flowmetry was also used to monitor changes in cerebral blood flow under TBI to supplement the investigation. Triphenyltetrazolium chloride (TTC) staining was used to monitor changes of infarction volume corresponding to different impact strengths. Result The experimental results indicated that concentration changes of HbO2 and total-hemoglobin (HbT) were significantly related to the impact strength. The infarction volume was also significantly related to the impact strength. Conclusion Therefore, the non-invasive monitoring of concentration changes in HbO2, HbR, and HbT using NIRS may have a clinical application for the evaluation of TBI.
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Affiliation(s)
- Bor-Shyh Lin
- Institute of Imaging and Biomedical Photonics, National Chiao-Tung University, Tainan, Taiwan. .,Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
| | - Che-Chuan Wang
- Institute of Photonic System, National Chiao-Tung University, No.901, Zhonghua Rd., Yongkang Dist., Tainan, 710, Taiwan. .,Division of Neurosurgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan. .,Department of Child Care, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
| | - Ming-Hsien Chang
- Institute of Imaging and Biomedical Photonics, National Chiao-Tung University, Tainan, Taiwan.
| | - Chung-Ching Chio
- Division of Neurosurgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.
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Somaini G, Stamm A, Müller-Mottet S, Hasler E, Keusch S, Hildenbrand FF, Furian M, Speich R, Bloch KE, Ulrich S. Disease-Targeted Treatment Improves Cognitive Function in Patients with Precapillary Pulmonary Hypertension. Respiration 2015; 90:376-83. [PMID: 26447714 DOI: 10.1159/000439227] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/24/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Patients with pulmonary hypertension (PH) may suffer from cognitive deficits that potentially relate to reduced oxygen delivery and cerebral tissue oxygenation (CTO). OBJECTIVE To evaluate the hypothesis that cognitive function improves with therapy, along with improved CTO. METHODS Twenty incident patients with arterial or chronic thromboembolic PH had CTO monitoring by near-infrared spectroscopy during diagnostic right heart catheterization. Cognitive tests [Trail Making Tests (TMTs), Victoria Stroop tests and the Five-Point Test (5PT)], the 6-min walk distance (6MWD) test, New York Heart Association (NYHA) class and health-related quality of life (HRQoL) were assessed and repeated after 3 months of disease-targeted medication. RESULTS At baseline, 45% of PH patients had cognitive deficits. At 3 months, the patients had improved on the TMT A and the Stroop 2 test [37 s (27; 55) versus 30 s (24; 42), p < 0.05, and 18 s (16; 22) versus 16 s (15; 20), p < 0.01], whereas CTO remained unchanged. Arterial oxygen saturation, NYHA class, 6MWD and HRQoL had also improved. Baseline CTO was the strongest predictor of cognitive function, even in multivariate analysis including age, 6MWD and HRQoL. Improvements in cognitive function were not associated with changes in CTO. CONCLUSIONS In patients with PH, 3 months of disease-targeted medication resulted in better cognitive function. Although CTO was the strongest predictor of cognitive function at baseline, it did not change during target therapy. The results of this pilot study should be confirmed in an adequately powered controlled trial.
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Affiliation(s)
- Gina Somaini
- Pulmonology Clinic, University Hospital Zurich, Zurich, Switzerland
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Vlisides P, Mashour GA. Perioperative stroke. Can J Anaesth 2015; 63:193-204. [PMID: 26391795 DOI: 10.1007/s12630-015-0494-9] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 07/02/2015] [Accepted: 09/11/2015] [Indexed: 12/15/2022] Open
Abstract
PURPOSE Perioperative stroke is associated with significant morbidity and mortality, with an incidence that may be underappreciated. In this review, we examine the significance, pathophysiology, risk factors, and evidence-based recommendations for the prevention and management of perioperative stroke. SOURCE This is a narrative review based on literature from the PubMed database regarding perioperative stroke across a broad surgical population. The Society for Neuroscience in Anesthesiology and Critical Care recently published evidence-based recommendations for perioperative management of patients at high risk for stroke; these recommendations were analyzed and incorporated into this review. PRINCIPAL FINDINGS The incidence of overt perioperative stroke is highest in patients presenting for cardiac and major vascular surgery, although preliminary data suggest that the incidence of covert stroke may be as high as 10% in non-cardiac surgery patients. The pathophysiology of perioperative stroke involves different pathways. Thrombotic stroke can result from increased inflammation and hypercoagulability; cardioembolic stroke can result from disease states such as atrial fibrillation, and tissue hypoxia from anemia can result from the combination of anemia and beta-blockade. Across large-scale database studies, common risk factors for perioperative stroke include advanced age, history of cerebrovascular disease, ischemic heart disease, congestive heart failure, atrial fibrillation, and renal disease. Recommendations for prevention and management of perioperative stroke are evolving, though further work is needed to clarify the role of proposed modifiable risk factors such as perioperative anticoagulation, antiplatelet therapy, appropriate transfusion thresholds, and perioperative beta-blockade. CONCLUSIONS Perioperative stroke carries a significant clinical burden. The incidence of perioperative stroke may be higher than previously recognized, and there are diverse pathophysiologic mechanisms. There are many opportunities for further investigation of the pathophysiology, prevention, and management of perioperative stroke.
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Affiliation(s)
- Phillip Vlisides
- Department of Anesthesiology, University of Michigan Health System, University Hospital 1H247, 1500 East Medical Center Drive, SPC 5048, Ann Arbor, MI, 48109, USA
| | - George A Mashour
- Department of Anesthesiology, University of Michigan Health System, University Hospital 1H247, 1500 East Medical Center Drive, SPC 5048, Ann Arbor, MI, 48109, USA.
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Addison PS. A Review of Wavelet Transform Time-Frequency Methods for NIRS-Based Analysis of Cerebral Autoregulation. IEEE Rev Biomed Eng 2015; 8:78-85. [PMID: 26011892 DOI: 10.1109/rbme.2015.2436978] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Near-infrared spectroscopy (NIRS) has been proposed as a suitable technique for the analysis of cerebral autoregulation as it provides a simpler acquisition methodology and more artifact-free signal. A number of sophisticated wavelet transform methods have recently emerged to quantify the cerebral autoregulation mechanism using NIRS and blood pressure signals. These provide an enhanced partitioning of signal information via the time-frequency plane, which facilitates improved extraction of the components of interest. This area is reviewed, and enhancements to this form of analysis are suggested.
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Tovedal T, Thelin S, Lennmyr F. Cerebral oxygen saturation during pulsatile and non-pulsatile cardiopulmonary bypass in patients with carotid stenosis. Perfusion 2015; 31:72-7. [PMID: 25948696 DOI: 10.1177/0267659115586280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pulsatile and non-pulsatile cardiopulmonary bypass (CPB) flows may have different impact on cerebral oxygen saturation in patients with restricted cerebral arterial blood supply. Twenty patients, ten diagnosed with carotid stenosis (CS, n = 10) and ten without known carotid disease (Controls, n = 10), were subjected to one period of pulsatile and one period of non-pulsatile flow (6-8 min each) during CPB at 32°C. Cerebral oxygen saturation was registered by near-infrared light spectroscopy (NIRS).The mean arterial pressure (MAP) was significantly lowered by pulsatile CPB flow. The NIRS tissue oxygenation index (TOI) tended to decrease in the CS group and increase in the Controls during pulsatile flow compared with non-pulsatile; however, the changes were not statistically significant.No significant correlations were seen between the changes in MAP and TOI across the observation periods.In conclusion, pulsatile CPB flow caused slightly decreased mean arterial pressure while the effect on cerebral oxygenation was unclear. Pulsatile flow was not found superior to non-pulsatile flow in patients with or without carotid stenosis.
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Affiliation(s)
- T Tovedal
- Department of Surgical Sciences, Section for Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
| | - S Thelin
- Department of Surgical Sciences, Section for Thoracic Surgery, Uppsala University, Uppsala, Sweden
| | - F Lennmyr
- Department of Surgical Sciences, Section for Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden
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Ricci Z, Haiberger R, Tofani L, Romagnoli S, Favia I, Cogo P. Multisite Near Infrared Spectroscopy During Cardiopulmonary Bypass in Pediatric Patients. Artif Organs 2015; 39:584-90. [DOI: 10.1111/aor.12424] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Zaccaria Ricci
- Department of Cardiology and Cardiac Surgery; Pediatric Cardiac Intensive Care Unit; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
| | - Roberta Haiberger
- Department of Cardiology and Cardiac Surgery; Pediatric Cardiac Intensive Care Unit; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
| | - Lorenzo Tofani
- Department of Neurosciences, Psychology, Drug Research and Child Health; University of Florence; Florence Italy
| | - Stefano Romagnoli
- Department of Human Health Sciences; Section of Anaesthesiology and Intensive Care; University of Florence; Azienda Ospedaliero-Universitaria Careggi; Florence Italy
| | - Isabella Favia
- Department of Cardiology and Cardiac Surgery; Pediatric Cardiac Intensive Care Unit; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
| | - Paola Cogo
- Department of Cardiology and Cardiac Surgery; Pediatric Cardiac Intensive Care Unit; Bambino Gesù Children's Hospital; IRCCS; Rome Italy
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Prospective evaluation of regional oxygen saturation to estimate central venous saturation in sepsis. J Clin Monit Comput 2015; 29:443-53. [PMID: 25757404 DOI: 10.1007/s10877-015-9683-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 02/27/2015] [Indexed: 01/01/2023]
Abstract
Current treatment guidelines for sepsis claim an early goal-directed hemodynamic optimization including fluid resuscitation, use of vasopressors and inotropic agents. We investigated the correlation between the prominent treatment goal central venous saturation (ScvO2) and the frontal and the thenar regional oxygen saturation (rSO2) measured by near infrared spectroscopy. Secondary, we examined the value of ScvO2, lactate levels and rSO2 as surrogate markers of an impaired tissue oxygenation for outcome prediction in sepsis. This prospective, observational study was performed at the surgical intensive care unit of the University Hospital Giessen. A total of 50 patients with sepsis, severe sepsis or septic shock were included. ScvO2, rSO2 and lactate were measured at sepsis diagnosis (baseline), 24 and 48 h, thereafter. We investigated the predictive value of frontal and thenar rSO2 for a decreased SvcO2 under 70%. For survivor and non-survivors ScvO2, rSO2 and lactate were analysed. Patients with ScvO2 >70% showed a trend to higher levels of fontal rSO2 (62.81 ± 8.06 vs. 53.54 ± 15.48; p = 0.058). ROC-analysis revealed a minor prediction of a decreased ScvO2 by frontal rSO2 levels at baseline (AUC = 0.687; 95% CI 0.511-0.863; p = 0.047). Combined measurements of lactate and ScvO2 showed significantly elevated mortality for patients with ScvO2 ≥70% and lactate levels ≥2.5 mmol/l (log rank test p = 0.004). In the group with ScvO2 <70% and lactate levels <2.5 mmol/l no patients died during the observation period. Frontal rSO2 correlates with ScvO2 but both frontal and thenar rSO2 do not exactly discriminate between patients with high or low ScvO2 in sepsis. The combination of elevated lactate >2.5 mmol/l and ScvO2 >70 % is highly associated with poor outcome in ICU patients with sepsis, severe sepsis and septic shock.
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Shellhaas RA, Burns JW, Wiggins SA, Christensen MK, Barks JDE, Chervin RD. Sleep-wake cycling and cerebral oxygen metabolism among critically ill neonates. J Child Neurol 2014; 29:530-3. [PMID: 23307884 PMCID: PMC3640647 DOI: 10.1177/0883073812470972] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Among adults, wakefulness and rapid eye movement (REM) sleep, compared to non-REM sleep, require higher overall brain metabolism, but in neonates analogous data are not available. Behavioral states with higher metabolic demand could increase vulnerability to hypoperfusion or hypoxia in the compromised neonatal brain. Using cerebral oximetry (near-infrared spectroscopy), and simultaneous polysomnography, we evaluated whether brain oxygen metabolism varies by sleep-wake state among critically ill newborns. For each of 10 infants, sleep-wake cycling was detectable and cerebral oximetry varied (P < .0001) across behavioral states, but the patterns differed among subjects. We conclude that cerebral oxygen metabolism varies with sleep-wake states in high-risk newborns. The direction and degree of these changes are variable and subject-specific in this initial sample, but could reflect or affect brain injury and vulnerability.
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Affiliation(s)
- Renée A Shellhaas
- Department of Pediatrics & Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - Joseph W Burns
- Michigan Tech Research Institute, Michigan Technological University, Ann Arbor, MI
| | - Stephanie A Wiggins
- Department of Pediatrics & Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - Mary K Christensen
- Department of Pediatrics & Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - John DE Barks
- Department of Pediatrics & Communicable Diseases, University of Michigan, Ann Arbor, MI
| | - Ronald D Chervin
- Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, MI
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Welliver RC, Mechlin C, Goodwin B, Alukal JP, McCullough AR. A Pilot Study to Determine Penile Oxygen Saturation Before and After Vacuum Therapy in Patients with Erectile Dysfunction After Radical Prostatectomy. J Sex Med 2014; 11:1071-1077. [DOI: 10.1111/jsm.12445] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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