NEAR-INFRARED SPECTROSCOPY IN ADULTS - EFFECTS OF EXTRACRANIAL ISCHEMIA AND INTRACRANIAL HYPOXIA ON ESTIMATION OF CEREBRAL OXYGENATION

被引:144
作者
GERMON, TJ [1 ]
KANE, NM [1 ]
MANARA, AR [1 ]
NELSON, RJ [1 ]
机构
[1] FRENCHAY HOSP,DEPT ANAESTHET,BRISTOL BS16 1LE,AVON,ENGLAND
关键词
MEASUREMENT TECHNIQUES; OXIMETERS; BRAIN; INJURY;
D O I
10.1093/bja/73.4.503
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We have studied the effects of extracranial ischaemia and intracranial hypoxia on measurement of cerebral oxygenation using near-infrared, reflectance-mode, cerebral oximetry (Invos 3100 cerebral oximeter) in healthy adult subjects. Under stable systemic conditions, scalp ischaemia induced by a pneumatic tourniquet caused an apparent reduction in mean regional cerebral oxygenation (rSo(2)) from mean 72 (SD 6)% to 59 (7)% (n = 8, P < 0.001). rSo(2) returned to control values within 1 min of release of the tourniquet. Local scalp ischaemia induced by rapid frontalis muscle exercise caused a significant reduction (4.5 (2)%) in rSo(2) (n = 12, P < 0.001). The effect of systemic hypoxia on rSo(2) was examined during controlled scalp ischaemia. A decrease in mean Sp(o2) from 98 (2)% to 66 (6)% was associated with a decrease in mean rSo(2) from 57 (4)% to 41 (6)%. There was a significant correlation between the percentage reduction in rSo(2) and SPo2 during hypoxia (r = 0.81, P < 0.001). We conclude that the Invos cerebral oximeter was capable of detecting tissue hypoxia deep to the scalp under carefully controlled conditions but that it also was affected significantly by changes in extracranial blood flow and oxygenation which may affect its reliability in clinical practice. Further work is necessary to define those situations in which cerebral oximetric monitoring is useful and valid.
引用
收藏
页码:503 / 506
页数:4
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