Skip to main content
Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 7/2018

26.02.2018 | Reports of Original Investigations

The effects of systemic oxygenation on cerebral oxygen saturation and its relationship to mixed venous oxygen saturation: A prospective observational study comparison of the INVOS and ForeSight Elite cerebral oximeters

verfasst von: Christian Schmidt, Matthias Heringlake, MD, Patrick Kellner, MD, Astrid Ellen Berggreen, MD, Holger Maurer, MD, Sebastian Brandt, MD, Bence Bucsky, MD, Michael Petersen, MD, Efstratios I. Charitos, MD, PhD

Erschienen in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Ausgabe 7/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The present study aimed to test the hypothesis that cerebral oxygen saturation (ScO2) measurements with the INVOS-5100-C and the ForeSight-Elite cerebral oximeters vary in their correlation with mixed venous oxygen saturation (SvO2) upon changes in systemic oxygenation in extubated cardiac surgical patients. Additionally, we aimed to elucidate whether the ScO2 measurements of both devices can be used interchangeably to detect reduced SvO2.

Methods

Forty-eight spontaneously breathing patients extubated after cardiac surgery were included in this prospective observational study. The patients were exposed to both high (10 oxygen L·min−1 via face mask) and low (room air) inspiratory oxygen concentrations. Bi-hemispherical ScO2 was determined with the INVOS and ForeSight Elite cerebral oximeters. The SvO2 was measured with a pulmonary artery catheter.

Results

Significant changes in oxygen delivery, ScO2 (by both cerebral oximeters), and SvO2 were observed upon variation of oxygenation. The minimum mean (standard deviation) ScO2 (ScO2min) using the INVOS and ForeSight did not differ significantly during high oxygen delivery [63.1 (8.6) % vs 65.8 (4.7) %, respectively; P = 0.07], but during low oxygen delivery, the INVOS value was significantly lower than that of the ForeSight oximeter [56.7 (8.9) % vs 61.3 (4.4) %, respectively; P = 0.003]. Both devices differed in the correlation between ScO2min and SvO2 for the combined oxygenation data (0.59, INVOS vs 0.28, ForeSight; correlation difference, 0.31; Bonferroni-adjusted 95% confidence interval [CI], 0.08 to 0.54; P = 0.008). The receiver-operating curve analysis revealed an area under the curve of 0.83 (95% CI, 0.74 to 0.9; P = 0.005) for detecting an SvO2 below 50% by ScO2min with the INVOS and 0.51 (95% CI, 0.41 to 0.62; P = 0.92), respectively, with the ForeSight.

Conclusions

These findings suggest that the cerebral oximeters tested react differently to variations in systemic oxygenation and in their relationship with SvO2 and thus give different information on cardiopulmonary function. These findings raise doubt about whether these devices should be used interchangeably.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Moerman A, Wouters P. Near-infrared spectroscopy (NIRS) monitoring in contemporary anesthesia and critical care. Acta Anaesthesiol Belg 2010; 61: 185-94.PubMed Moerman A, Wouters P. Near-infrared spectroscopy (NIRS) monitoring in contemporary anesthesia and critical care. Acta Anaesthesiol Belg 2010; 61: 185-94.PubMed
2.
Zurück zum Zitat Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth 2009; 103(Supplement 1): i3-13.CrossRefPubMed Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth 2009; 103(Supplement 1): i3-13.CrossRefPubMed
3.
Zurück zum Zitat Slater JP, Guarino T, Stack J, et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg 2009; 87: 36-44.CrossRefPubMed Slater JP, Guarino T, Stack J, et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg 2009; 87: 36-44.CrossRefPubMed
4.
Zurück zum Zitat de Tournay-Jetté E, Dupuis G, Bherer L, Deschamps A, Cartier R, Denault A. The relationship between cerebral oxygen saturation changes and postoperative cognitive dysfunction in elderly patients after coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2011; 25: 95-104.CrossRefPubMed de Tournay-Jetté E, Dupuis G, Bherer L, Deschamps A, Cartier R, Denault A. The relationship between cerebral oxygen saturation changes and postoperative cognitive dysfunction in elderly patients after coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 2011; 25: 95-104.CrossRefPubMed
5.
Zurück zum Zitat Casati A, Fanelli G, Pietropaoli P, et al. Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: a prospective cohort study. Eur J Anaesthesiol 2007; 24: 59-65.PubMed Casati A, Fanelli G, Pietropaoli P, et al. Monitoring cerebral oxygen saturation in elderly patients undergoing general abdominal surgery: a prospective cohort study. Eur J Anaesthesiol 2007; 24: 59-65.PubMed
6.
Zurück zum Zitat Murkin JM, Adams SJ, Novick RJ, et al. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized. prospective study. Anesth Analg 2007; 104: 51-8.CrossRefPubMed Murkin JM, Adams SJ, Novick RJ, et al. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized. prospective study. Anesth Analg 2007; 104: 51-8.CrossRefPubMed
7.
Zurück zum Zitat Mohandas BS, Jagadeesh AM, Vikram SB. Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery. Ann Card Anaesth 2013; 16: 102-6.CrossRefPubMed Mohandas BS, Jagadeesh AM, Vikram SB. Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery. Ann Card Anaesth 2013; 16: 102-6.CrossRefPubMed
8.
Zurück zum Zitat Colak Z, Borojevic M, Bogovic A, Ivancan V, Biocina B, Majeric-Kogler V. Influence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized. prospective study. Eur J Cardiothorac Surg 2015; 47: 447-54.CrossRefPubMed Colak Z, Borojevic M, Bogovic A, Ivancan V, Biocina B, Majeric-Kogler V. Influence of intraoperative cerebral oximetry monitoring on neurocognitive function after coronary artery bypass surgery: a randomized. prospective study. Eur J Cardiothorac Surg 2015; 47: 447-54.CrossRefPubMed
9.
Zurück zum Zitat Meng L, Xiao J, Gudelunas K, Yu Z, Zhong Z, Hu X. Association of intraoperative cerebral and muscular tissue oxygen saturation with postoperative complications and length of hospital stay after major spine surgery: an observational study. Br J Anaesth 2017; 118: 551-62.CrossRefPubMed Meng L, Xiao J, Gudelunas K, Yu Z, Zhong Z, Hu X. Association of intraoperative cerebral and muscular tissue oxygen saturation with postoperative complications and length of hospital stay after major spine surgery: an observational study. Br J Anaesth 2017; 118: 551-62.CrossRefPubMed
10.
Zurück zum Zitat Paarmann H, Heringlake M, Heinze H, et al. Non-invasive cerebral oxygenation reflects mixed venous oxygen saturation during the varying haemodynamic conditions in patients undergoing transapical transcatheter aortic valve implantation. Interact Cardiovasc Thorac Surg 2012; 3: 268-72.CrossRef Paarmann H, Heringlake M, Heinze H, et al. Non-invasive cerebral oxygenation reflects mixed venous oxygen saturation during the varying haemodynamic conditions in patients undergoing transapical transcatheter aortic valve implantation. Interact Cardiovasc Thorac Surg 2012; 3: 268-72.CrossRef
11.
Zurück zum Zitat Schön J, Heringlake M, Berger KU, Volker Groesdonk H, Sedemund-Adib B, Paarmann H. Relationship between mixed venous oxygen saturation and regional cerebral oxygenation in awake. spontaneously breathing cardiac surgery patients. Minerva Anestesiol 2011; 77: 952-8.PubMed Schön J, Heringlake M, Berger KU, Volker Groesdonk H, Sedemund-Adib B, Paarmann H. Relationship between mixed venous oxygen saturation and regional cerebral oxygenation in awake. spontaneously breathing cardiac surgery patients. Minerva Anestesiol 2011; 77: 952-8.PubMed
12.
Zurück zum Zitat Moerman A, Vandenplas G, Bové T, De Wouters PF, Hert SG. Relation between mixed venous oxygen saturation and cerebral oxygen saturation measured by absolute and relative near-infrared spectroscopy during off-pump coronary artery bypass grafting. Br J Anaesth 2013; 110: 258-65.CrossRefPubMed Moerman A, Vandenplas G, Bové T, De Wouters PF, Hert SG. Relation between mixed venous oxygen saturation and cerebral oxygen saturation measured by absolute and relative near-infrared spectroscopy during off-pump coronary artery bypass grafting. Br J Anaesth 2013; 110: 258-65.CrossRefPubMed
13.
Zurück zum Zitat Meng L, Cannesson M, Alexander BS, et al. Effect of phenylephrine and ephedrine bolus treatment on cerebral oxygenation in anaesthetized patients. Br J Anaesth 2011; 107: 209-17.CrossRefPubMedPubMedCentral Meng L, Cannesson M, Alexander BS, et al. Effect of phenylephrine and ephedrine bolus treatment on cerebral oxygenation in anaesthetized patients. Br J Anaesth 2011; 107: 209-17.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Heringlake M, Garbers C, Käbler JH, et al. Preoperative cerebral oxygen saturation and clinical outcomes in cardiac surgery. Anesthesiology 2011; 114: 58-69.CrossRefPubMed Heringlake M, Garbers C, Käbler JH, et al. Preoperative cerebral oxygen saturation and clinical outcomes in cardiac surgery. Anesthesiology 2011; 114: 58-69.CrossRefPubMed
15.
Zurück zum Zitat Douds MT, Straub EJ, Kent AC, Bistrick CH, Sistino JJ. A systematic review of cerebral oxygenation-monitoring devices in cardiac surgery. Perfusion 2014; 29: 545-52.CrossRefPubMed Douds MT, Straub EJ, Kent AC, Bistrick CH, Sistino JJ. A systematic review of cerebral oxygenation-monitoring devices in cardiac surgery. Perfusion 2014; 29: 545-52.CrossRefPubMed
16.
Zurück zum Zitat Davie SN, Grocott HP. Impact of extracranial contamination on regional cerebral oxygen saturation: a comparison of three cerebral oximetry technologies. Anesthesiology 2012; 116: 834-40.CrossRefPubMed Davie SN, Grocott HP. Impact of extracranial contamination on regional cerebral oxygen saturation: a comparison of three cerebral oximetry technologies. Anesthesiology 2012; 116: 834-40.CrossRefPubMed
17.
Zurück zum Zitat Greenberg S, Murphy G, Shear T, et al. Extracranial contamination in the INVOS 5100C versus the FORE-SIGHT ELITE cerebral oximeter: a prospective observational crossover study in volunteers. Can J Anesth 2016; 63: 24-30.CrossRefPubMed Greenberg S, Murphy G, Shear T, et al. Extracranial contamination in the INVOS 5100C versus the FORE-SIGHT ELITE cerebral oximeter: a prospective observational crossover study in volunteers. Can J Anesth 2016; 63: 24-30.CrossRefPubMed
18.
Zurück zum Zitat Bickler PE, Feiner JR, Rollins MD. Factors affecting the performance of 5 cerebral oximeters during hypoxia in healthy volunteers. Anesth Analg 2013; 117: 813-23.CrossRefPubMed Bickler PE, Feiner JR, Rollins MD. Factors affecting the performance of 5 cerebral oximeters during hypoxia in healthy volunteers. Anesth Analg 2013; 117: 813-23.CrossRefPubMed
19.
Zurück zum Zitat Zheng F, Sheinberg R, Yee MS, Ono M, Zheng Y, Hogue CW. Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg 2013; 116: 663-76.CrossRefPubMed Zheng F, Sheinberg R, Yee MS, Ono M, Zheng Y, Hogue CW. Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg 2013; 116: 663-76.CrossRefPubMed
21.
Zurück zum Zitat Zhou GY. Toward using confidence intervals to compare correlations. Psychological Methods 2007; 12: 399-413.CrossRef Zhou GY. Toward using confidence intervals to compare correlations. Psychological Methods 2007; 12: 399-413.CrossRef
22.
Zurück zum Zitat Deschamps A, Hall R, Grocott H, et al. Cerebral oximetry monitoring to maintain normal cerebral oxygen saturation during high-risk cardiac surgery: a randomized controlled feasibility trial. Anesthesiology 2016; 124: 826-36.CrossRefPubMed Deschamps A, Hall R, Grocott H, et al. Cerebral oximetry monitoring to maintain normal cerebral oxygen saturation during high-risk cardiac surgery: a randomized controlled feasibility trial. Anesthesiology 2016; 124: 826-36.CrossRefPubMed
23.
Zurück zum Zitat Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Semin Cardiothorac Vasc Anesth 2007; 11: 274-81.CrossRefPubMed Denault A, Deschamps A, Murkin JM. A proposed algorithm for the intraoperative use of cerebral near-infrared spectroscopy. Semin Cardiothorac Vasc Anesth 2007; 11: 274-81.CrossRefPubMed
25.
Zurück zum Zitat Brady K, Joshi B, Zweifel C, et al. Real-time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass. Stroke 2010; 41: 1951-6.CrossRefPubMedPubMedCentral Brady K, Joshi B, Zweifel C, et al. Real-time continuous monitoring of cerebral blood flow autoregulation using near-infrared spectroscopy in patients undergoing cardiopulmonary bypass. Stroke 2010; 41: 1951-6.CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Fischer GW. Recent advances in application of cerebral oximetry in adult cardiovascular surgery. Semin Cardiothorac Vasc Anesth 2008; 12: 60-9.CrossRefPubMed Fischer GW. Recent advances in application of cerebral oximetry in adult cardiovascular surgery. Semin Cardiothorac Vasc Anesth 2008; 12: 60-9.CrossRefPubMed
27.
Zurück zum Zitat Kim J, Shim JK, Song JW, Kim EK, Kwak YL. Postoperative cognitive dysfunction and the change of regional cerebral oxygen saturation in elderly patients undergoing spinal surgery. Anesth Analg 2016; 123: 436-44.CrossRefPubMed Kim J, Shim JK, Song JW, Kim EK, Kwak YL. Postoperative cognitive dysfunction and the change of regional cerebral oxygen saturation in elderly patients undergoing spinal surgery. Anesth Analg 2016; 123: 436-44.CrossRefPubMed
Metadaten
Titel
The effects of systemic oxygenation on cerebral oxygen saturation and its relationship to mixed venous oxygen saturation: A prospective observational study comparison of the INVOS and ForeSight Elite cerebral oximeters
verfasst von
Christian Schmidt
Matthias Heringlake, MD
Patrick Kellner, MD
Astrid Ellen Berggreen, MD
Holger Maurer, MD
Sebastian Brandt, MD
Bence Bucsky, MD
Michael Petersen, MD
Efstratios I. Charitos, MD, PhD
Publikationsdatum
26.02.2018
Verlag
Springer US
Erschienen in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Ausgabe 7/2018
Print ISSN: 0832-610X
Elektronische ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-018-1093-3

Weitere Artikel der Ausgabe 7/2018

Canadian Journal of Anesthesia/Journal canadien d'anesthésie 7/2018 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.