1 January 1998 Can near-infrared spectroscopy be used for detection of perioperative severe cerebral ischemia?
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Accurate quantification of near-infrared (NIRS) signal changes during monitoring of the adult head is required for regular clinical use. By incorporating NIRS into a multimodal monitoring system, which documents cerebral haemodynamic changes during carotid endarterectomy, we have provided the opportunity for calibration against parameters known to warn of severe cerebral ischaemia (SCI) under controlled anaesthesia. Application of a particular protocol in which clamping of the External Carotid Artery was performed two minutes before the Internal Carotid Artery enabled isolation of the NIRS measurements from the intracranial tissue. This way the most profound problem in adult NIRS, extracranial contamination, has been successfully addressed. In consequence, NIRS derived thresholds for intraoperative cerebral ischaemia showed in a series of 76 patients high agreement with criteria defined using transcranial Doppler and the cerebral function monitor. In contrast, when non-corrected for extracranial components NIRS measurements were used no thresholds for SCI were apparent.
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Piotr Smielewski, Piotr Smielewski, Joseph M. K. Lam, Joseph M. K. Lam, Pippa G. Al-Rawi, Pippa G. Al-Rawi, Marek Czosnyka, Marek Czosnyka, Peter J. Kirkpatrick, Peter J. Kirkpatrick, "Can near-infrared spectroscopy be used for detection of perioperative severe cerebral ischemia?", Proc. SPIE 3194, Photon Propagation in Tissues III, (1 January 1998); doi: 10.1117/12.301036; https://doi.org/10.1117/12.301036

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