Relationship Between Brain Tissue Oxygen and Near-Infrared Spectroscopy in Patients with Nontraumatic Subarachnoid Hemorrhage.

Autor: de Courson H; Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France.; U1219, Bordeaux Population Health, Institut National de la Santé et de la Recherche Médicale, University of Bordeaux, Bordeaux, France., Proust-Lima C; U1219, Bordeaux Population Health, Institut National de la Santé et de la Recherche Médicale, University of Bordeaux, Bordeaux, France., Tuaz E; Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France., Georges D; Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France., Verchère E; Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France., Biais M; Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France. matthieu.biais@chu-bordeaux.fr.; U1034, Biology of Cardiovascular Diseases, Institut National de la Santé et de la Recherche Médicale, University of Bordeaux, Bordeaux, France. matthieu.biais@chu-bordeaux.fr.
Jazyk: angličtina
Zdroj: Neurocritical care [Neurocrit Care] 2022 Dec; Vol. 37 (3), pp. 620-628. Date of Electronic Publication: 2022 Jul 25.
DOI: 10.1007/s12028-022-01563-7
Abstrakt: Background: Continuous monitoring of cerebral oxygenation is one of the diagnostic tools used in patients with brain injury. Direct and invasive measurement of cerebral oxygenation with a partial brain oxygen pressure (PbtO 2 ) probe is promising but invasive. Noninvasive assessment of regional transcranial oxygen saturation using near-infrared spectroscopy (NIRS) may be feasible. The aim of this study was to evaluate the interchangeability between PbtO 2 and NIRS over time in patients with nontraumatic subarachnoid hemorrhage.
Methods: This retrospective study was performed in a neurocritical care unit. Study participants underwent hourly PbtO 2 and NIRS measurements over 72 h. Temporal agreement between markers was described by their pointwise correlation. A secondary analysis assessed the structure of covariation between marker trajectories using a bivariate linear mixed model.
Results: Fifty-one patients with subarachnoid hemorrhage were included. A total of 3362 simultaneous NIRS and PbtO 2 measurements were obtained. The correlation at each measurement time ranged from - 0.25 to 0.25. The global correlation over time was - 0.026 (p = 0.130). The bivariate linear mixed model confirmed the lack of significant correlation between the PbtO 2 and NIRS measurements at follow-up. NIRS was unable to detect PbtO 2 values below 20 mm Hg (area under the receiver operating characteristic curve 0.539 [95% confidence interval 0.536-0.542]; p = 0.928), and percentage changes in NIRS were unable to detect a decrease in PbtO 2  ≥ 10% (area under the receiver operating characteristic curve 0.615 [95% confidence interval 0.614-0.616]; p < 0.001).
Conclusions: PbtO 2 and NIRS measurements were not correlated. There is no evidence that NIRS could be a substitute for PbtO 2 monitoring in patients with nontraumatic subarachnoid hemorrhage.
(© 2022. Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society.)
Databáze: MEDLINE
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