Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-24T14:08:17.240Z Has data issue: false hasContentIssue false
  • English
  • Français

Monitoring of cerebral oxygenation with near infrared spectroscopy and tissue oxygen partial pressure during cardiopulmonary resuscitation in pigs

Published online by Cambridge University Press:  01 March 2006

B. Bein ,
E. Cavus ,
K. H. Stadlbauer ,
P. H. Tonner ,
M. Steinfath ,
J. Scholz  and
V. Dörges
B. Bein
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany
E. Cavus
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany
K. H. Stadlbauer
Affiliation:
Medical University Innsbruck, Department of Anaesthesiology and Intensive Care Medicine, Innsbruck, Austria
P. H. Tonner
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany
M. Steinfath
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany
J. Scholz
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany
V. Dörges
Affiliation:
University Hospital Schleswig-Holstein, Department of Anaesthesiology and Intensive Care Medicine, Kiel, Germany
Get access

Extract

Summary

Background and objective: The present study was designed to compare cerebral oxygenation measured with near infrared spectroscopy and local brain tissue oxygen partial pressure, respectively, in pigs during cardiopulmonary resuscitation. Since tissue overlying the brain may have an impact on near infrared spectroscopy readings, we tested whether optode placement on intact skin or on the skull yielded comparable results. Methods: Twelve healthy pigs were anaesthetized and subjected to continuous haemodynamic, near infrared spectroscopy and brain tissue oxygen partial pressure monitoring. After 4 min of untreated ventricular fibrillation, cardiopulmonary resuscitation was started and arginine vasopressin was administered repeatedly three times. Near infrared spectroscopy values recorded were both the tissue oxygenation index and the tissue haemoglobin index as well as relative changes of chromophores (haemoglobin and cytochrome oxidase). Four animals served as control and were measured with both near infrared spectroscopy optodes mounted on the intact skin of the forehead, while in the remaining eight animals, one near infrared spectroscopy optode was implanted directly on the skull. Results: Near infrared spectroscopy readings at the skin or at the skull differed consistently throughout the study period. After arginine vasopressin administration, near infrared spectroscopy values at the different locations showed a transient dissociation. In contrast to near infrared spectroscopy measured on intact skin, near infrared spectroscopy readings obtained from skull showed a significant correlation to brain tissue oxygen partial pressure values (r = 0.67, P < 0.001). Conclusion: Near infrared spectroscopy readings obtained from skin and skull differed largely after vasopressor administration. Near infrared spectroscopy optode placement therefore may have an important influence on the tissue region investigated.

Keywords

CEREBROVASCULAR CIRCULATIONOXYGENATION, BRAINCARDIOPULMONARY RESUSCITATIONSPECTROSCOPY NEAR INFRAREDMODELS, ANIMAL, pig
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 6 , June 2006 , pp. 501 - 509
Copyright
© 2006 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Owen-Reece H, Smith M, Elwell CE, Goldstone JC. Near infrared spectroscopy. Br J Anaesth 1999; 82: 418–426.Google Scholar
Dunham CM, Sosnowski C, Porter JM et al. Correlation of noninvasive cerebral oximetry with cerebral perfusion in the severe head injured patient: a pilot study. J Trauma 2002; 52: 40–46.Google Scholar
Kirkpatrick PJ, Smielewski P, Czosnyka M et al. Near-infrared spectroscopy use in patients with head injury. J Neurosurg 1995; 83: 963–970.Google Scholar
Lewis SB, Myburgh JA, Thornton EL, Reilly PL. Cerebral oxygenation monitoring by near-infrared spectroscopy is not clinically useful in patients with severe closed-head injury: a comparison with jugular venous bulb oximetry. Crit Care Med 1996; 24: 1334–1338.Google Scholar
Bein B, Cavus E, Dorges V et al. Arginine vasopressin reduces cerebral oxygenation and cerebral blood volume during intact circulation in swine – a near infrared spectroscopy study. Eur J Anaesthesiol 2005; 22: 62–66.Google Scholar
Cavus E, Dorges V, Wagner-Berger H et al. Changes of local brain tissue oxygen pressure after vasopressin during spontaneous circulation. Acta Neurochir (Wien) 2005; 147: 283–290; discussion 90.Google Scholar
Prengel AW, Lindner KH, Keller A. Cerebral oxygenation during cardiopulmonary resuscitation with epinephrine and vasopressin in pigs. Stroke 1996; 27: 1241–1248.Google Scholar
Doornbos RM, Lang R, Aalders MC et al. The determination of in vivo human tissue optical properties and absolute chromophore concentrations using spatially resolved steady-state diffuse reflectance spectroscopy. Phys Med Biol 1999; 44: 967–981.Google Scholar
Wagner BP, Pfenninger J. Dynamic cerebral autoregulatory response to blood pressure rise measured by near-infrared spectroscopy and intracranial pressure. Crit Care Med 2002; 30: 2014–2021.Google Scholar
Barfield CP, Yu VY, Noma O et al. Cerebral blood volume measured using near-infrared spectroscopy and radiolabels in the immature lamb brain. Pediatr Res 1999; 46: 50–56.Google Scholar
Wickramasinghe YA, Livera LN, Spencer SA et al. Plethysmographic validation of near infrared spectroscopic monitoring of cerebral blood volume. Arch Dis Child 1992; 67: 407–411.Google Scholar
Quaresima V, Sacco S, Totaro R, Ferrari M. Noninvasive measurement of cerebral hemoglobin oxygen saturation using two near infrared spectroscopy approaches. J Biomed Opt 2000; 5: 201–205.Google Scholar
Sakamoto T, Jonas RA, Stock UA et al. Utility and limitations of near-infrared spectroscopy during cardiopulmonary bypass in a piglet model. Pediatr Res 2001; 49: 770–776.Google Scholar
Germon TJ, Evans PD, Barnett NJ et al. Cerebral near infrared spectroscopy: emitter–detector separation must be increased. Br J Anaesth 1999; 82: 831–837.Google Scholar
Germon TJ, Evans PD, Manara AR et al. Sensitivity of near infrared spectroscopy to cerebral and extra-cerebral oxygenation changes is determined by emitter–detector separation. J Clin Monit Comput 1998; 14: 353–360.Google Scholar
Al-Rawi PG, Smielewski P, Kirkpatrick PJ. Evaluation of a near-infrared spectrometer (NIRO 300) for the detection of intracranial oxygenation changes in the adult head. Stroke 2001; 32: 2492–2500.Google Scholar
Kuebler WM, Sckell A, Habler O et al. Noninvasive measurement of regional cerebral blood flow by near-infrared spectroscopy and indocyanine green. J Cerebr Blood Flow Metab 1998; 18: 445–456.Google Scholar
Friesenecker B, Tsai AG, Dunser MW et al. Oxygen distribution in microcirculation after arginine vasopressin-induced arteriolar vasoconstriction. Am J Physiol Heart Circ Physiol 2004; 287: H1792–H1800.Google Scholar
Suzuki Y, Satoh S, Oyama H et al. Regional differences in the vasodilator response to vasopressin in canine cerebral arteries in vivo. Stroke 1993; 24: 1049–1053; discussion 53–54.Google Scholar
Villringer K, Minoshima S, Hock C, Delpy DT. Assessment of local brain activation. A simultaneous PET and near-infrared spectroscopy study. In: Villringer A, Dirnagl U eds., Optical Imaging of Brain Function and Metabolism, Vol 2. New York, USA: Plenum, 1997: 149–153.
Young AE, Germon TJ, Barnett NJ et al. Behaviour of near-infrared light in the adult human head: implications for clinical near-infrared spectroscopy. Br J Anaesth 2000; 84: 38–42.Google Scholar
Kirkpatrick PJ, Lam J, Al-Rawi P et al. Defining thresholds for critical ischemia by using near-infrared spectroscopy in the adult brain. J Neurosurg 1998; 89: 389–394.Google Scholar
Manley GT, Pitts LH, Morabito D et al. Brain tissue oxygenation during hemorrhagic shock, resuscitation, and alterations in ventilation. J Trauma 1999; 46: 261–267.Google Scholar
Safar P, Behringer W, Bottiger BW, Sterz F. Cerebral resuscitation potentials for cardiac arrest. Crit Care Med 2002; 30: S140–S144.Google Scholar
Krasznai L, Grote EH. Acute vasoparalysis after subarachnoid haemorrhage and cerebral trauma: general reflex phenomenon? Neurol Res 1994; 16: 40–44.Google Scholar
Delpy DT, Cope M, van der Zee P et al. Estimation of optical pathlength through tissue from direct time of flight measurement. Phys Med Biol 1988; 33: 1433–1442.Google Scholar