title: Development and validation of a multiwavelength spatial domain near-infrared oximeter to detect cerebral hypoxia-ischemia.
abstract: Detection of cerebral hypoxia-ischemia in infants remains problematic, as current monitors in clinical practice are impractical, insensitive, or nonspecific. Our study develops a multiwavelength spatial domain construct for near-infrared spectroscopy (NIRS) to detect cerebral hypoxia-ischemia and evaluates the construct in several models. The NIRS probe contains photodiode detectors 2, 3, and 4 cm from a three-wavelength, light-emitting diode. A construct determines cerebral O(2) saturation based on spatial domain principles. Device performance and construct validity are examined in in-vitro models simulating the brain, and in piglets subjected to hypoxia, hypoxia-ischemia, and hyperoxic conditions using a weighted average of arterial and cerebral venous O(2) saturation measured by CO-oximetry. The results in the brain models verify key equations in the construct and demonstrate reliable performance of the device. In piglets, the device measures cerebral O(2) saturation with bias +/-4% and precision +/-8%. In conclusion, this NIRS device accurately detects cerebral hypoxia-ischemia and is of a design that is practical for clinical application.
authors.affiliation: Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Department of Anesthesia and Pediatrics, Institute of Pediatric Anesthesia, Cincinnati, Ohio 45229-3039, USA.
authors.forename: Lindsey A
authors.initials: LA
authors.lastname: Nelson
authors.forename: John C
authors.initials: JC
authors.lastname: McCann
authors.forename: Andres W
authors.initials: AW
authors.lastname: Loepke
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
authors.forename: Baruch
authors.initials: B
authors.lastname: Ben Dor
authors.forename: C Dean
authors.initials: CD
authors.lastname: Kurth
mesh_terms: D000465:Algorithms; D000818:Animals; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D020925:Hypoxia-Ischemia, Brain / Q000097:blood* / Q000175:diagnosis*; D010092:Oximetry / Q000295:instrumentation* / Q000379:methods; D010100:Oxygen / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013055:Spectrophotometry, Infrared / Q000295:instrumentation* / Q000379:methods; D013552:Swine
chemical_list: D010100:Oxygen