1 May 2008 Brain oxymetry in the operating room: current status and future directions with particular regard to cytochrome oxidase
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Abstract
Near-infrared spectroscopy (NIRS) is a cerebral monitoring method that noninvasively and continuously measures cerebral hemoglobin oxygenation and the redox state of cytochrome oxidase using highly tissue-permeable near-infrared light. This technique now has wide clinical application, and its usefulness in the measurement of cerebral hemoglobin oxygenation has been confirmed under global cerebral injury and/or hypoxemic hypoxia; however, regional cerebral infarction located far from the monitoring site may not be detected by NIRS. Furthermore, the specificity and accuracy of the measurement of the redox state of cytochrome oxidase remain controversial. We apply NIRS to both animal and clinical investigations. Based on these results, we discuss the significance of the measurement of cerebral hemoglobin oxygenation and cytochrome oxidase in vivo and in clinical medicine. Using our algorithm, cytochrome oxidase signals are unaffected by hemoglobin signals, even when hematocrit values change from 35 to 5% under cardiopulmonary bypass in a dog model. In the clinical study, cytochrome oxidase during surgery is likely to be a good (though not perfect) predictor of postoperative cerebral outcome. NIRS appears to be a promising technology, but additional investigations are required to establish its clinical efficacy and justify its routine use during operative and perioperative periods.
© (2008) Society of Photo-Optical Instrumentation Engineers (SPIE)
Yasuyuki Kakihana, Akira Matsunaga, Tomotsugu Yasuda, Toru Imabayashi, Yuichi Kanmura, Mamoru Tamura, "Brain oxymetry in the operating room: current status and future directions with particular regard to cytochrome oxidase," Journal of Biomedical Optics 13(3), 033001 (1 May 2008). https://doi.org/10.1117/1.2940583 . Submission:
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