Continuous-wave near-infrared spectroscopy is not related to brain tissue oxygen tension.
Near-infrared spectroscopy (NIRS) has gained acceptance for cerebral monitoring, especially during cardiac surgery, though there are few data showing its validity. We therefore aimed to correlate invasive brain tissue oxygen measurements (PtiO2) with the corresponding NIRS-values (regional oxygen saturation, rSO2). We also studied whether NIRS was able to detect ischemic events, defined as a PtiO2-value of <15 mmHg. Eleven patients were studied with invasive brain tissue oxygen monitoring and continuous-wave NIRS. PtiO2-correlation with corresponding NIRS-values was calculated. We found no correlation between PtiO2- and NIRS-readings. Measurement of rSO2 was no better than flipping a coin in the detection of cerebral ischemia when a commonly agreed ischemic PtiO2 cut-off value of <15 mmHg was chosen. Continuous-wave-NIRS was unable to reliably detect ischemic cerebral episodes, defined as a PtiO2 value <15 mmHg. Displayed NIRS-values did not correlate with invasively measured PtiO2-values. CW-NIRS should not be used for the detection of cerebral ischemia.
Department of Neurosurgery, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany. kerz@uni-mainz.de.
Thomas
T
Kerz
Department of Neurosurgery, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
Christian
C
Beyer
Ludmillenstift, Meppen, Germany.
Alexandra
A
Huthmann
Department of Neurosurgery, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
Darius
D
Kalasauskas
Department of Neurosurgery, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
Amr Nimer
AN
Amr
University Medical Center, Institute of Neuroradiology, Johannes Gutenberg University, Mainz, Germany.
Stephan
S
Boor
Department of Neurosurgery, University Medical Center, Johannes Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
Stefan
S
Welschehold
D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology / Q000502:physiology; D001926:Brain Death / Q000473:pathology; D002545:Brain Ischemia / Q000473:pathology; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D000072226:Computed Tomography Angiography / Q000379:methods; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D010092:Oximetry / Q000379:methods*; D010100:Oxygen / Q000378:metabolism; D012372:ROC Curve; D012680:Sensitivity and Specificity; D019265:Spectroscopy, Near-Infrared / Q000379:methods*; D013345:Subarachnoid Hemorrhage / Q000378:metabolism; D013997:Time Factors
D010100:Oxygen
Brain death; Brain oxygen tension; Brain trauma; Near-infrared spectroscopy; Subarachnoid haemorrhage