Version 1
: Received: 16 March 2024 / Approved: 18 March 2024 / Online: 18 March 2024 (13:20:29 CET)
How to cite:
Lukaszewski, M.; Nelke, K. Near Infrared Spectroscopy (NIRS) in the Assessment of Cerebral Tissue Oxygenation (rSO2) - Methodological Issues and Dilemmas. Preprints2024, 2024031041. https://doi.org/10.20944/preprints202403.1041.v1
Lukaszewski, M.; Nelke, K. Near Infrared Spectroscopy (NIRS) in the Assessment of Cerebral Tissue Oxygenation (rSO2) - Methodological Issues and Dilemmas. Preprints 2024, 2024031041. https://doi.org/10.20944/preprints202403.1041.v1
Lukaszewski, M.; Nelke, K. Near Infrared Spectroscopy (NIRS) in the Assessment of Cerebral Tissue Oxygenation (rSO2) - Methodological Issues and Dilemmas. Preprints2024, 2024031041. https://doi.org/10.20944/preprints202403.1041.v1
APA Style
Lukaszewski, M., & Nelke, K. (2024). Near Infrared Spectroscopy (NIRS) in the Assessment of Cerebral Tissue Oxygenation (rSO2) - Methodological Issues and Dilemmas. Preprints. https://doi.org/10.20944/preprints202403.1041.v1
Chicago/Turabian Style
Lukaszewski, M. and Kamil Nelke. 2024 "Near Infrared Spectroscopy (NIRS) in the Assessment of Cerebral Tissue Oxygenation (rSO2) - Methodological Issues and Dilemmas" Preprints. https://doi.org/10.20944/preprints202403.1041.v1
Abstract
Introduction
The monitoring of cerebral perfusion in patients with brain damage is a major clinical challenge. Monitoring cerebral oxygenation (rSO2) by NIRS was introduced at the turn of the 1980s, and many clinicians believed it was a valuable method for assessing cerebral perfusion and subsequent measures to optimize cerebral flow. The main problem of NIRS usage is the presence of the intermediate structures-skin, skull, meninges, cerebrospinal fluid-and their influence on the outcome of the test. Therefore, it seems that NIRS assessment performed on a patient during brain death attempts, can give an idea of the magnitude of the influence of these intermediate structures on the monitoring result.
Case
We present a retrospective analysis of cerebral oxygenation measurements of a patient undergoing a brain death diagnostic procedure. A clinical situation where the cerebral blood flow is stopped can give an idea of the specificity of the method, particularly the impact of the influence of intermediate structures on the monitoring outcome. In this case, the NIRS result is increased by the oxygenation of the patient before the apnoea test. The influence of chromophores in the tissues surrounding the CNS, reflections and scattering of the light wave spectrum have a very significant effect on the final result of cerebral saturation measurement.
Discussion
The majority of research observations describing changes in cerebral perfusion or its optimisation may be burdened by the problem described, i.e. the significant influence of measured oxygenation from intermediate structures. The specificity of NIRS to assess cerebral perfusion requires careful analysis. The therapeutic implications of monitoring cerebral oxygenation with NIRS are of great importance and, from the example presented and the literature provided, the method should be used with caution. It has been shown that in a patient with brain death, the result of NIRS oxygenation measurements depends on the surrounding structures of the brain.
Keywords
Near Infrared Spectroscopy; Monitoring cerebral oxygenation
Subject
Medicine and Pharmacology, Anesthesiology and Pain Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
