Evaluation of a near-infrared spectrometer (NIRO 300) for the detection of intracranial oxygenation changes in the adult head
Evaluation of a near-infrared spectrometer (NIRO 300) for the detection of intracranial oxygenation changes in the adult head
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DOI：
10.1161/hs1101.098356
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发表时间：
2001-11-01
期刊：
影响因子：
8.3
通讯作者：
Kirkpatrick, PJ
中科院分区：
文献类型：
--
作者：
Al-Rawi, PG;Smielewski, P;Kirkpatrick, PJ
背景和目的：颅内近红外光谱在成人中的临床应用一直受到颅外组织污染的影响。NIRO 300（Hamamatsu Photonics）提供血红蛋白和细胞色素氧化酶浓度的连续在线测量以及计算的组织氧指数（TOI）。本研究旨在确认TOI在成人cranium.Methods-Sixty例接受颈动脉内膜切除术的解剖来源。NIRO 300被纳入一个既定的多模式监测系统。TOI、氧合血红蛋白和脱氧血红蛋白的变化进行了评估，并与（1）额部皮肤激光多普勒血流仪和（2）经颅多普勒测量同侧大脑中动脉血流velocity.Results-Changes在TOI中观察到49例患者在交叉夹闭颈动脉时（平均Δ TOI=-9.4%，SD =7.1）。TOI与血流速度呈显著相关（r=0.56），但与激光多普勒血流仪无相关性（r=0.13）。在31例患者中，氧合血红蛋白和脱氧血红蛋白浓度被记录，显示在颈外动脉和颈内动脉夹闭期间均发生显著变化。TOI的变化主要与颈内动脉夹闭相关（n=41）。当TOI在颈外动脉夹闭期间改变时（n=8），发生显著的血压变化，或颅外-颅内吻合明显。在这些变量的情况下，TOI颅内和颅外变化的敏感性分别为87.5%和0%，特异性分别为100%和0%，foreign. Conclusions NIRO 300反映脑组织氧合变化时，TOI计算，具有高度的敏感性和特异性。
Background and Purpose-The clinical application of intracranial near-infrared spectroscopy in adults has been hampered by concerns over contamination from extracranial tissues. The NIRO 300 (Hamamatsu Photonics) provides continuous online measurements of hemoglobin and cytochrome oxidase concentrations and a calculated tissue oxygen index (TOI). The present study seeks confirmation of the anatomic source of TOI in the adult cranium.Methods-Sixty patients undergoing carotid endarterectomy were studied. The NIRO 300 was incorporated into an established multimodal monitoring system. TOI, oxyhemoglobin, and deoxyhemoglobin changes were assessed and compared with (1) frontal cutaneous laser-Doppler flowmetry and (2) transcranial Doppler measurement of the ipsilateral middle cerebral artery flow velocity.Results-Changes in TOI were seen during cross-clamping of the carotid vessels in 49 patients (mean Delta TOI= -9.4%, SD=7.1). Significant correlation was seen between TOI and flow velocity (r=0.56) but not with laser-Doppler flowmetry (r=0.13). In 31 patients, oxyhemoglobin and deoxyhemoglobin concentrations were recorded, showing significant changes during both external carotid artery and internal carotid artery clamping. A change in TOI was predominantly associated with internal carotid artery clamping (n=41). When TOI changed during external carotid artery clamping (n=8), significant blood pressure changes occurred, or extracranial-to-intracranial anastomosis was evident. In the absence of such variables, the sensitivity of TOI to intracranial and extracranial changes was 87.5% and 0%, respectively, and specificity was 100% and 0%, respectively.Conclusions-The NIRO 300 reflects changes in cerebral tissue oxygenation when TOI is calculated, with a high degree of sensitivity and specificity.