The feature of brain oxygenation in the sleep cycle of healthy newborn babies

Noninvasive monitoring brain oxygenation with near-infrared spectroscopy (NIRS) is becoming a widely used in neonatology for determine the optimal target oxygen saturation during resuscitation of newborns, but its use in clinical practice for diagnostics and prognosis perinatal pathology is limited because intra and especially interpatient variability are too large for this aim. This study aimed to determine cerebral oximetry values during the sleep cycle and wakefulness in healthy full term newborns. 38 newborns (gestational age 38 weeks were included in this study (22 after normal birth I group and 16 after cesarean section). Near-infrared spectroscopy (CrSO2) from left fronto-parietal region was recorded in synchrony with polysomnography. Continuous cerebral CrSO2 were measured using near-infrared spectroscopy (Somanetic INVOS 5100C, USA). Fraction tissue oxygen extraction (FTOE) was calculated using SaO2 (pulse oximeter Radical Masimo) and CrSO2 (FTOE = (SаO2 CrSO2)/SаO2). CrSO2 and SаO2 were analyzed during 15 minutes polysomnography-defined quiet, active sleep and wakefulness (defined according to standard guidelines). The results: cerebral oxygen saturation varies with sleep-wake states: during active sleep (74,18 0,75%) was similar to the value in wakefulness (75,6 1,0%) and smaller than in quiet sleep (81,93 1,74%, р 0,001), but FTOE during active sleep was significantly higher (0,221 0,008% and 0,129 0,005%, p 0,001). There were no differences of rates between groups. The high oxygen consumption during REM sleep supports its role during postnatal brain functional development. The use of NIRS taking into account sleep structure will be new method for diagnostic and prognosis perinatal pathology CNS.

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A noninvasive estimation of mixed venous oxygen saturation using near-infrared spectroscopy by cerebral oximetry in pediatric cardiac surgery patients

Pediatric Anesthesia ◽

10.1111/j.1460-9592.2005.01488.x ◽

2005 ◽

Vol 15 (6) ◽

pp. 495-503 ◽

Cited By ~ 132

Author(s):

TIA A. TORTORIELLO ◽

STEPHEN A. STAYER ◽

ANTONIO R. MOTT ◽

E. DEAN McKENZIE ◽

CHARLES D. FRASER ◽

...

Keyword(s):

Cardiac Surgery ◽

Infrared Spectroscopy ◽

Oxygen Saturation ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Mixed Venous Oxygen Saturation ◽

Cerebral Oximetry ◽

Noninvasive Estimation ◽

Venous Oxygen Saturation ◽

Mixed Venous

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Arterial and Venous Contributions to Near-infrared Cerebral Oximetry

Anesthesiology ◽

10.1097/00000542-200010000-00012 ◽

2000 ◽

Vol 93 (4) ◽

pp. 947-953 ◽

Cited By ~ 280

Author(s):

H. Marc Watzman ◽

C. Dean Kurth ◽

Lisa M. Montenegro ◽

Jonathan Rome ◽

James M. Steven ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Oxygen Saturation ◽

Frequency Domain ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Arterial Oxygen Saturation ◽

Fixed Ratio ◽

Cerebral Oximetry ◽

Infrared Light ◽

Arterial Oxygen

Background Cerebral oximetry is a noninvasive bedside technology using near-infrared light to monitor cerebral oxygen saturation (Sco2) in an uncertain mixture of arteries, capillaries, and veins. The present study used frequency domain near-infrared spectroscopy to determine the ratio of arterial and venous blood monitored by cerebral oximetry during normoxia, hypoxia, and hypocapnia. Methods Twenty anesthetized children aged < 8 yr with congenital heart disease of varying arterial oxygen saturation (Sao2) were studied during cardiac catheterization. Sco2, Sao2, and jugular bulb oxygen saturation (Sjo2) were measured by frequency domain near-infrared spectroscopy and blood oximetry at normocapnia room air, normocapnia 100% inspired O2, and hypocapnia room air. Results Among subject conditions, Sao2 ranged from 68% to 100%, Sjo2 from 27% to 96%, and Sco2 from 29% to 92%. Sco2 was significantly related to Sao2 (y = 0. 85 x -17, r = 0.47), Sjo2 (y = 0.77 x +13, r = 0.70), and the combination (Sco2 = 0.46 Sao2 + 0.56 Sjo2 - 17, R = 0.71). The arterial and venous contribution to cerebral oximetry was 16 +/- 21% and 84 +/- 21%, respectively (where Sco2 = alpha Sao2 + beta Sjo2 with alpha and beta being arterial and venous contributions). The contribution was similar among conditions but differed significantly among subjects (range, approximately 40:60 to approximately 0:100, arterial:venous). Conclusions Cerebral oximetry monitors an arterial/venous ratio of 16:84, similar in normoxia, hypoxia, and hypocapnia. Because of biologic variation in cerebral arterial/venous ratios, use of a fixed ratio is not a good method to validate the technology.

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The Accuracy of a Near-Infrared Spectroscopy Cerebral Oximetry Device and Its Potential Value for Estimating Jugular Venous Oxygen Saturation

Anesthesia & Analgesia ◽

10.1213/ane.0000000000000463 ◽

2014 ◽

Vol 119 (6) ◽

pp. 1381-1392 ◽

Cited By ~ 37

Author(s):

Keita Ikeda ◽

David B. MacLeod ◽

Hilary P Grocott ◽

Eugene W. Moretti ◽

Warwick Ames ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Oxygen Saturation ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Cerebral Oximetry ◽

Potential Value ◽

Jugular Venous Oxygen Saturation ◽

Venous Oxygen Saturation

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Efficacy of near-infrared spectroscopy cerebral oximetry on detection of critical cerebral perfusion during carotid endarterectomy under regional anesthesia

VASA ◽

10.1024/0301-1526/a000879 ◽

2020 ◽

Vol 49 (5) ◽

pp. 367-374

Author(s):

João P. Rocha-Neves ◽

Juliana Pereira-Macedo ◽

André L. Moreira ◽

José P. Oliveira-Pinto ◽

Graça Afonso ◽

...

Keyword(s):

Infrared Spectroscopy ◽

Oxygen Saturation ◽

Carotid Endarterectomy ◽

Regional Anesthesia ◽

Near Infrared Spectroscopy ◽

Operating Characteristic ◽

Near Infrared ◽

Cerebral Oximetry ◽

Cerebral Hypoperfusion ◽

Cerebral Oxygen

Summary: Background: Patients undergoing carotid endarterectomy (CEA) may suffer from cerebral hypoperfusion during the carotid cross-clamping. Near-infrared spectroscopy cerebral oximetry (NIRS) is a non-invasive method of regional cerebral oxygen saturation measurement reflecting changes in cerebral blood flow during CEA. The main goal of the study was to evaluate the accuracy of the NIRS in detecting cerebral hypoperfusion during CEA under regional anesthesia (RA) and compare it with awake neurological testing. Patients and methods: A prospective observational study of 28 patients that underwent CEA in RA and manifested neurologic deficits, and 28 consecutive controls from a tertiary and referral center, was performed. All patients were monitored with NIRS cerebral oximetry and awake testing as the control technique. Subsequently, operating characteristic curve and Cohen’s kappa coefficient were determined to evaluate the reliability of the monitoring test. Results: NIRS presented a sensitivity of 27.3% and a specificity of 89.3% in comparison to awake testing. Receiver operating characteristic (ROC) curve analysis demonstrated that a decrease of at least 20% in cerebral oxygen saturation is the best threshold to infer cerebral hypoperfusion. However, the respective area under the curve (AUROC) was 0.606 (95% CI: 0.456–0.756, P = 0.178) with a calculated Cohen’s kappa of 0.179, P = 0.093. Regarding 30-days outcomes, only awake testing has shown significant associations with stroke and postoperative complications ( P = 0.043 and P = 0.05), which were higher in patients with post-clamping neurologic deficits. Conclusions: NIRS demonstrated a reduced discriminative capacity for critical cerebral hypoperfusion, and does not seem to add substantial clinical benefits to the awake test.

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Modern experience in conducting cerebral oximetry in neonatology: review

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(3)-28 ◽

2020 ◽

Vol 24 (3) ◽

pp. 543-549

Author(s):

A.О. Vlasov

Keyword(s):

Infrared Spectroscopy ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Transition Period ◽

Scientific Data ◽

Cerebral Oximetry ◽

Prognostic Indicators ◽

Normative Values ◽

Brain Oxygenation ◽

Non Invasive

Annotation. Near-infrared spectroscopy (NIRS), non-invasive monitoring of tissue oxygenation in many organs, has potentially high diagnostic and prognostic value in critically ill patients. Aim – to analyze modern scientific data on cerebral oximetry by near infrared spectroscopy in neonatal practice. A selective review of literature science data on Internet databases: Pub Med, UpToDate, Medscape EU and Pediatrics was carried out in retrospect. It has been established that understanding neonatal brain oxygenation may be of great clinical importance, since most neonatal pathology is associated with the brain. Vital monitoring provides important information about the infant's health, but does not offer direct information about oxygenation and brain perfusion. Monitoring brain oxygenation with NIRS, at least during the vulnerable transition period during the first 3 days after birth, provides the clinician with additional important information. It can guide clinical management to prevent brain injury and prevent unnecessary treatment, and can provide important information about the infant’s prognosis. Thus, NIRS is a promising non-invasive technology that provides continuous monitoring of neonatal oxygenation parameters. Significant limitations of the method are the difficulties in the clinical interpretation of regional oxygenation indices, the lack of large-scale studies to determine the normative values of regional oxygenation in newborns and to identify reliable prognostic indicators in violation of regional blood circulation. It is reasonable to expect the results of further research.

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