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Bruins AA, Geboers DGPJ, Bauer JR, Klaessens JHGM, Verdaasdonk RM, Boer C. The vascular occlusion test using multispectral imaging: a validation study : The VASOIMAGE study. J Clin Monit Comput 2020; 35:113-121. [PMID: 31902095 DOI: 10.1007/s10877-019-00448-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 12/14/2019] [Indexed: 12/11/2022]
Abstract
Multispectral imaging (MSI) is a new, non-invasive method to continuously measure oxygenation and microcirculatory perfusion, but has limitedly been validated in healthy volunteers. The present study aimed to validate the potential of multispectral imaging in the detection of microcirculatory perfusion disturbances during a vascular occlusion test (VOT). Two consecutive VOT's were performed on healthy volunteers and tissue oxygenation was measured with MSI and near-infrared spectroscopy (NIRS). Correlations between the rate of desaturation, recovery and the hyperemic area under the curve (AUC) measured by MSI and NIRS were calculated. Fifty-eight volunteers were included. The MSI oxygenation curves showed identifiable components of the VOT, including a desaturation and recovery slope and hyperemic area under the curve, similar to those measured with NIRS. The correlation between the rate of desaturation measured by MSI and NIRS was moderate: r = 0.42 (p = 0.001) for the first and r = 0.41 (p = 0.002) for the second test. Our results suggest that non-contact multispectral imaging is able to measure changes in regional oxygenation and deoxygenation during a vascular occlusion test in healthy volunteers. When compared to measurements with NIRS, correlation of results was moderate to weak, most likely reflecting differences in physiology of the regions of interest and measurement technique.
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Affiliation(s)
- Arnoud A Bruins
- Departments of Anesthesiology, Amsterdam UMC, VU University, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. .,Amsterdam Cardiovascular Sciences, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
| | - Diederik G P J Geboers
- Departments of Anesthesiology, Amsterdam UMC, VU University, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Jacob R Bauer
- The Norwegian Colour and Visual Computing Laboratory, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - John H G M Klaessens
- Department of Clinical Physics, Medical Center Leeuwarden, Leeuwarden, The Netherlands
| | - Rudolf M Verdaasdonk
- TechMed Center, BioMedical Photonics & Medical Imaging, University of Twente, Enschede, The Netherlands
| | - Christa Boer
- Departments of Anesthesiology, Amsterdam UMC, VU University, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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Bruins AA, Kistemaker KRJ, Boom A, Klaessens JHGM, Verdaasdonk RM, Boer C. Thermographic skin temperature measurement compared with cold sensation in predicting the efficacy and distribution of epidural anesthesia. J Clin Monit Comput 2017; 32:335-341. [PMID: 28508148 PMCID: PMC5838146 DOI: 10.1007/s10877-017-0026-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/28/2017] [Indexed: 11/25/2022]
Abstract
Due to the high rates of epidural failure (3-32%), novel techniques are required to objectively assess the successfulness of an epidural block. In this study we therefore investigated whether thermographic temperature measurements have a higher predictive value for a successful epidural block when compared to the cold sensation test as gold standard. Epidural anesthesia was induced in 61 patients undergoing elective abdominal, thoracic or orthopedic surgery. A thermographic picture was recorded at 5, 10 and 15 min following epidural anesthesia induction. After 15 min a cold sensation test was performed. Epidural anesthesia is associated with a decrease in skin temperature. Thermography predicts a successful epidural block with a sensitivity of 54% and a PPV of 92% and a specificity of 67% and a NPV of 17%. The cold sensation test shows a higher sensitivity and PPV than thermography (97 and 93%), but a lower specificity and NPV than thermography (25 and 50%). Thermographic temperature measurements can be used as an additional and objective method for the assessment of the effectiveness of an epidural block next to the cold sensation test, but have a low sensitivity and negative predictive value. The local decrease in temperature as observed in our study during epidural anesthesia is mainly attributed to a core-to-peripheral redistribution of body heat and vasodilation.
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Affiliation(s)
- Arnoud A Bruins
- Department of Anesthesiology, Institute for Cardiovascular Research, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Kay R J Kistemaker
- Department of Anesthesiology, Institute for Cardiovascular Research, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Annemieke Boom
- Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands
| | - John H G M Klaessens
- Department of Physics and Medical Technology, Institute for Cardiovascular Research, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Rudolf M Verdaasdonk
- Department of Physics and Medical Technology, Institute for Cardiovascular Research, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Christa Boer
- Department of Anesthesiology, Institute for Cardiovascular Research, VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
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