title: Extracranial contamination in the INVOS 5100C versus the FORE-SIGHT ELITE cerebral oximeter: a prospective observational crossover study in volunteers.
abstract: OBJECTIVE
  Previous studies have found that most cerebral oximeters are subject to inaccuracies secondary to extracranial contamination of the cerebral oximetric signals. We hypothesized that the more advanced second-generation FORE-SIGHT ELITE cerebral oximeter would be significantly less affected by extracranial tissue hypoxemia than the more widely used first-generation INVOS™ 5100C monitor.
  
  
  METHODS
  Twenty healthy volunteers aged 18-45 yr had the INVOS and FORE-SIGHT probes placed on their forehead in a random sequence while in the supine position. A pneumatic head cuff was then placed around each volunteer's head just below both the oximeter and a concomitantly placed scalp forehead pulse oximeter probe. The subjects' scalp cerebral oxygen saturation (SctO2) values were measured and compared using the two different devices in sequence, both before and after scalp tissue ischemia was induced by the pneumatic cuff.
  
  
  RESULTS
  Extracranial ischemia resulted in a significant reduction in SctO2 values from baseline in both devices. The INVOS 5100C recorded a median [interquartile range] decrease in SctO2 from baseline at five minutes of 15.1% [12.6 - 17.6], while that recorded by the FORESIGHT ELITE device was 8.6% [4.0 -12.3] at five minutes (median difference, 7.9%; 99% confidence interval, 1.9 to 16.5; P = 0.002).
  
  
  CONCLUSIONS
  Updated technological algorithms employed in the FORE-SIGHT ELITE cerebral oximeter may be responsible for less extracranial contamination than was observed in the previous-generation INVOS 5100C device. The impact that this extracranial contamination may have on the clinical use of these devices remains to be determined.
authors: NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL, 60201, USA. sbgreenb@gmail.com.|Pritzker School of Medicine, University of Chicago, Chicago, IL, USA. sbgreenb@gmail.com.
authors: Steven
authors: S
authors: Greenberg
authors: NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL, 60201, USA.|Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors: Glenn
authors: G
authors: Murphy
authors: NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL, 60201, USA.|Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors: Torin
authors: T
authors: Shear
authors: NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL, 60201, USA.
authors: Aashka
authors: A
authors: Patel
authors: NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL, 60201, USA.
authors: Andrew
authors: A
authors: Simpson
authors: NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL, 60201, USA.|Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors: Joseph
authors: J
authors: Szokol
authors: Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors: Michael J
authors: MJ
authors: Avram
authors: NorthShore University HealthSystem, 2650 Ridge Ave., Evanston, IL, 60201, USA.|Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors: Jeffery
authors: J
authors: Vender
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D001921:Brain / Q000378:metabolism; D018592:Cross-Over Studies; D064368:Healthy Volunteers; D010092:Oximetry / Q000295:instrumentation / Q000592:standards; D011446:Prospective Studies