An Innovative Approach in Emergency Medicine: Monitoring Brain Oxygenation with Cerebral Oximetry

Year 2024, , 147 - 151, 28.07.2024

Özgen Gönenç Çekiç

https://doi.org/10.56766/ntms.1427994

Abstract

The monitoring of cerebral oxygenation is a method that is not commonly integrated into the majority of existing emergency departments(ED), but it has attracted increasing attention, particularly in recent years. As the severity of ischemia escalates during cardiopulmonary resuscitation(CPR), the probability of both survival and favorable neurological outcomes diminishes. Therefore, the imperative development of methods to quantify the magnitude of ischemia, particularly cerebral ischemia, during resuscitation is critical for enhancing overall outcomes. Cerebral oximetry, using near-infrared spectroscopy, represents a noninvasive method for measuring brain oxygenation. The objective of this manuscript is to present an overview of the application of cerebral oximetry in the ED.

Keywords

Oximetry, Spectroscopy, Near- infrared, Emergencies

Ethical Statement

None

Supporting Institution

None

References

• 1. Ali J, Cody J, Maldonado Y, Ramakrishna H. Near-Infrared Spectroscopy (NIRS) for Cerebral and Tissue Oximetry: Analysis of Evolving Applications. J Cardiothorac Vasc Anesth. 2022; 36:2758-66.
• 2. Jobsis FF. Noninvasive, infrared monitoring of cerebral and myocardial oxygen sufficiency and circulatory parameters. Science. 1977; 198(4323):1264-67.
• 3. Tosh W, Patteril M. Cerebral oximetry. BJA Education. 2016; 16(12):417-21.
• 4. Pellicer A, Bravo Mdel C. Near-infrared spectroscopy: a methodology-focused review. Semin Fetal Neonatal Med. 2011; 16(1):42-49.
• 5. Elser HE, Holditch-Davis D, Brandon DH. Cerebral Oxygenation Monitoring: A Strategy to Detect IVH and PVL. Newborn Infant Nurs Rev. 2011; 11(3):153-59.
• 6. Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth. 2009; 103(Suppl 1):3-13.
• 7. Kato S, Yoshitani K, Kubota Y, Inatomi Y, Ohnishi Y. Effect of posture and extracranial contamination on results of cerebral oximetry by near-infrared spectroscopy. J Anesth. 2017; 31(1):103-10.
• 8. Davie SN, Grocott HP. Impact of extracranial contamination on regional cerebral oxygen saturation: a comparison of three cerebral oximetry technologies. Anesthesiology. 2012; 116(4):834-40.
• 9. Bickler PE, Feiner JR, Rollins MD. Factors affecting the performance of 5 cerebral oximeters during hypoxia in healthy volunteers. Anesth Analg. 2013; 117(4):813-23.
• 10. Sun X, Ellis J, Corso PJ, Hill PC, Chen F, Lindsay J. Skin pigmentation interferes with the clinical measurement of regional cerebral oxygen saturation. Br J Anaesth. 2015; 114(2):276-80.
• 11. Robba C, Battaglini D, Rasulo F, Lobo FA, Matta B. The importance of monitoring cerebral oxygenation in non brain injured patients. J Clin Monit Comput. 2023; 37(4):943-49.
• 12. American Society of Anesthesiologists Task Force on Perioperative Blood Management. Practice guidelines for perioperative blood management: an updated report by the American Society of Anesthesiologists Task Force on Perioperative Blood Management. Anesthesiology. 2015; 122(2):241-75.
• 13. Moore CC, Yu S, Aljure O. A comprehensive review of cerebral oximetry in cardiac surgery. J Card Surg. 2022; 37(12):5418-33.
• 14. 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(3):447-54.
• 15. Cormack F, Shipolini A, Awad WI, et al. A meta-analysis of cognitive outcome following coronary artery bypass graft surgery. Neurosci Biobehav Rev. 2012; 36(9):2118-2129.
• 16. Huppert EL, Parnia S. Cerebral oximetry: a developing tool for monitoring cerebral oxygenation during cardiopulmonary resuscitation. Ann N Y Acad Sci. 2022; 1509(1):12-22.
• 17. Hoiland RL, Ainslie PN, Wellington CL, et al. Brain Hypoxia Is Associated With Neuroglial Injury in Humans Post-Cardiac Arrest. Circ Res. 2021; 129(5):583-97.
• 18. Smith K, Andrew E, Lijovic M, Nehme Z, Bernard S. Quality of life and functional outcomes 12 months after out-of-hospital cardiac arrest. Circulation. 2015; 131(2):174-81.
• 19. Genbrugge C, Dens J, Meex I, et al. Regional Cerebral Oximetry During Cardiopulmonary Resuscitation: Useful or Useless? J Emerg Med. 2016; 50(1):198-207.
• 20. Genbrugge C, De Deyne C, Eertmans W, et al. Cerebral saturation in cardiac arrest patients measured with near-infrared technology during pre-hospital advanced life support. Results from Copernicus I cohort study. Resuscitation. 2018; 129:107-13.
• 21. Sanfilippo F, Murabito P, Messina A, et al. Cerebral regional oxygen saturation during cardiopulmonary resuscitation and return of spontaneous circulation: A systematic review and meta-analysis. Resuscitation. 2021; 159:19-27.
• 22. Shin J, Walker R, Blackwood J, et al. Cerebral Oximetry during Out-of-Hospital Resuscitation: Pilot Study of First Responder Implementation. Prehosp Emerg Care. 2022; 26(4):519-23.
• 23. Henningsson A, Lannemyr L, Angeras O, et al. Prehospital monitoring of cerebral circulation during out of hospital cardiac arrest ? A feasibility study. Scand J Trauma Resusc Emerg Med. 2022; 30(1):62.
• 24. Liu Y, Jing K, Liu H, et al. Association between cerebral oximetry and return of spontaneous circulation following cardiac arrest: A systematic review and meta-analysis. PLoS One. 2020; 15(8):e0234979.
• 25. Thiele RH, Shaw AD, Bartels K, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on the Role of Neuromonitoring in Perioperative Outcomes: Cerebral Near-Infrared Spectroscopy. Anesth Analg. 2020; 131(5):1444-55.
• 26. Cournoyer A, Iseppon M, Chauny JM, Denault A, Cossette S, Notebaert E. Near-infrared Spectroscopy Monitoring During Cardiac Arrest: A Systematic Review and Meta-analysis. Acad Emerg Med. 2016; 23(8):851-62.
• 27. Battaglini D, Santori G, Chandraptham K, et al. Neurological Complications and Noninvasive Multimodal Neuromonitoring in Critically Ill Mechanically Ventilated COVID-19 Patients. Front Neurol. 2020; 11:602114.
• 28. Crippa IA, Subira C, Vincent JL, et al. Impaired cerebral autoregulation is associated with brain dysfunction in patients with sepsis. Crit Care. 2018; 22(1):327.
• 29. Rivera-Lara L, Geocadin R, Zorrilla-Vaca A, et al. Validation of Near-Infrared Spectroscopy for Monitoring Cerebral Autoregulation in Comatose Patients. Neurocrit Care. 2017; 27(3):362-69. Ono M, Zheng Y, Joshi B, Sigl JC, Hogue CW. Validation of a stand-alone near-infrared spectroscopy system for monitoring cerebral autoregulation during cardiac surgery. Anesth Analg. 2013; 116(1):198-204.