J Neuroanaesth Crit Care 2015; 02(03): 221-224
DOI: 10.4103/2348-0548.165045
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Near-infrared spectroscopy

Virendra Jain
1   Department of Anaesthesiology and Pain Medicine, Fortis Memorial Research Institute, Gurgaon, Haryana, India
,
Hari H Dash
1   Department of Anaesthesiology and Pain Medicine, Fortis Memorial Research Institute, Gurgaon, Haryana, India
› Author Affiliations

Subject Editor:
Further Information

Publication History

Publication Date:
02 May 2018 (online)

Abstract

Tissue ischaemia can be a significant contributor to increased morbidity and mortality. Conventional oxygenation monitoring modalities measure systemic oxygenation, but regional tissue oxygenation is not monitored. Near-infrared spectroscopy (NIRS) is a non-invasive monitor for measuring regional oxygen saturation which provides real-time information. There has been increased interest in the clinical application of NIRS following numerous studies that show improved outcome in various clinical situations especially cardiac surgery. Its use has shown improved neurological outcome and decreased postoperative stay in cardiac surgery. Its usefulness has been investigated in various high risk surgeries such as carotid endarterectomy, thoracic surgeries, paediatric population and has shown promising results. There is however, limited data supporting its role in neurosurgical population. We strongly feel, it might play a key role in future. It has significant advantages over other neuromonitoring modalities, but more technological advances are needed before it can be used more widely into clinical practice.

 
  • REFERENCES

  • 1 Scheeren TW, Schober P, Schwarte LA. Monitoring tissue oxygenation by near infrared spectroscopy (NIRS): Background and current applications. J Clin Monit Comput 2012; 26: 279-87
  • 2 Smith M. Perioperative uses of transcranial perfusion monitoring. Neurosurg Clin N Am 2008; 19: 489-502 vii
  • 3 Highton D, Elwell C, Smith M. Noninvasive cerebral oximetry: Is there light at the end of the tunnel?. Curr Opin Anaesthesiol 2010; 23: 576-81
  • 4 Jöbsis FF. Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science 1977; 198: 1264-7
  • 5 Gupta N, Dash HH. Neuromonitoring. In: Mehta Y. editor. Textbook of Critical Care. 1st ed.. New Delhi: Jaypee Publishers; 2015. p. 66-89
  • 6 Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth 2009; 103 Suppl (Suppl. 01) i3-13
  • 7 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
  • 8 Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I. et al. Monitoring brain oxygen saturation during coronary bypass surgery: A randomized, prospective study. Anesth Analg 2007; 104: 51-8
  • 9 Slater JP, Guarino T, Stack J, Vinod K, Bustami RT, Brown 3rd JM. et al. Cerebral oxygen desaturation predicts cognitive decline and longer hospital stay after cardiac surgery. Ann Thorac Surg 2009; 87: 36-44
  • 10 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
  • 11 Vohra HA, Modi A, Ohri SK. Does use of intra-operative cerebral regional oxygen saturation monitoring during cardiac surgery lead to improved clinical outcomes?. Interact Cardiovasc Thorac Surg 2009; 9: 318-22
  • 12 Samra SK, Dy EA, Welch K, Dorje P, Zelenock GB, Stanley JC. Evaluation of a cerebral oximeter as a monitor of cerebral ischemia during carotid endarterectomy. Anesthesiology 2000; 93: 964-70
  • 13 Mille T, Tachimiri ME, Klersy C, Ticozzelli G, Bellinzona G, Blangetti I. et al. Near infrared spectroscopy monitoring during carotid endarterectomy: Which threshold value is critical?. Eur J Vasc Endovasc Surg 2004; 27: 646-50
  • 14 Hayashida M, Kin N, Tomioka T, Orii R, Sekiyama H, Usui H. et al. Cerebral ischaemia during cardiac surgery in children detected by combined monitoring of BIS and near-infrared spectroscopy. Br J Anaesth 2004; 92: 662-9
  • 15 Yamamoto A, Yokoyama N, Yonetani M, Uetani Y, Nakamura H, Nakao H. Evaluation of change of cerebral circulation by SpO2 in preterm infants with apneic episodes using near infrared spectroscopy. Pediatr Int 2003; 45: 661-4
  • 16 Murphy GS, Szokol JW, Marymont JH, Greenberg SB, Avram MJ, Vender JS. et al. Cerebral oxygen desaturation events assessed by near-infrared spectroscopy during shoulder arthroscopy in the beach chair and lateral decubitus positions. Anesth Analg 2010; 111: 496-505
  • 17 Hemmerling TM, Bluteau MC, Kazan R, Bracco D. Significant decrease of cerebral oxygen saturation during single-lung ventilation measured using absolute oximetry. Br J Anaesth 2008; 101: 870-5
  • 18 Bhatia R, Hampton T, Malde S, Kandala NB, Muammar M, Deasy N. et al. The application of near-infrared oximetry to cerebral monitoring during aneurysm embolization: A comparison with intraprocedural angiography. J Neurosurg Anesthesiol 2007; 19: 97-104
  • 19 Dunham CM, Ransom KJ, Flowers LL, Siegal JD, Kohli CM. Cerebral hypoxia in severely brain-injured patients is associated with admission Glasgow Coma Scale score, computed tomographic severity, cerebral perfusion pressure, and survival. J Trauma 2004; 56: 482-9
  • 20 Leal-Noval SR, Cayuela A, Arellano-Orden V, Marín-Caballos A, Padilla V, Ferrándiz-Millón C. et al. Invasive and noninvasive assessment of cerebral oxygenation in patients with severe traumatic brain injury. Intensive Care Med 2010; 36: 1309-17
  • 21 Gopinath SP, Robertson CS, Contant CF, Narayan RK, Grossman RG, Chance B. Early detection of delayed traumatic intracranial hematomas using near-infrared spectroscopy. J Neurosurg 1995; 83: 438-44
  • 22 Robertson CS, Gopinath SP, Chance B. A new application for near-infrared spectroscopy: Detection of delayed intracranial hematomas after head injury. J Neurotrauma 1995; 12: 591-600
  • 23 Gill AS, Rajneesh KF, Owen CM, Yeh J, Hsu M, Binder DK. Early optical detection of cerebral edema in vivo . J Neurosurg 2011; 114: 470-7
  • 24 Kim MN, Edlow BL, Durduran T, Frangos S, Mesquita RC, Levine JM. et al. Continuous optical monitoring of cerebral hemodynamics during head-of-bed manipulation in brain-injured adults. Neurocrit Care 2014; 20: 443-53
  • 25 Steiner LA, Pfister D, Strebel SP, Radolovich D, Smielewski P, Czosnyka M. Near-infrared spectroscopy can monitor dynamic cerebral autoregulation in adults. Neurocrit Care 2009; 10: 122-8
  • 26 Lee JK, Brady KM, Mytar JO, Kibler KK, Carter EL, Hirsch KG. et al. Cerebral blood flow and cerebrovascular autoregulation in a swine model of pediatric cardiac arrest and hypothermia. Crit Care Med 2011; 39: 2337-45