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

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An Invited Commentary to this article was published on 25 July 2022

Abstract

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 (PbtO2) 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 PbtO2 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 PbtO2 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 PbtO2 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 PbtO2 and NIRS measurements at follow-up. NIRS was unable to detect PbtO2 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 PbtO2 ≥ 10% (area under the receiver operating characteristic curve 0.615 [95% confidence interval 0.614–0.616]; p < 0.001).

Conclusions

PbtO2 and NIRS measurements were not correlated. There is no evidence that NIRS could be a substitute for PbtO2 monitoring in patients with nontraumatic subarachnoid hemorrhage.

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Acknowledgements

The authors thank Catherine Bigotto and Laure Estève for technical support and Musa Sesay for English-language editing.

Funding

This study was supported by institutional and departmental funds.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France

    Hugues de Courson, Estelle Tuaz, Delphine Georges, Eric Verchère & Matthieu Biais

  2. U1219, Bordeaux Population Health, Institut National de la Santé et de la Recherche Médicale, University of Bordeaux, Bordeaux, France

    Hugues de Courson & C. Proust-Lima

  3. U1034, Biology of Cardiovascular Diseases, Institut National de la Santé et de la Recherche Médicale, University of Bordeaux, Bordeaux, France

    Matthieu Biais

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  1. Hugues de Courson
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Contributions

HdC: recruited patients, collected the data, performed the statistical analysis, and wrote the manuscript. CP-L: analyzed the data and helped in writing the manuscript. ET: recruited patients, collected the data, and helped in writing the manuscript. DG: helped in the recruitment of patients, in data analysis, and in writing the manuscript. EV: helped in the recruitment of patients, in data analysis, and in writing the manuscript. MB: designed the study, helped in data analysis, and in writing the manuscript. All authors approved the final version.

Corresponding author

Correspondence to Matthieu Biais.

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Conflicts of interest

MB received honoraria from Edwards Lifesciences and Pulsion Medical System as a lecturer. The other authors have no competing interests.

Ethical approval/informed consent

The study was approved by the Institutional Review Board of the French Society of Anesthesia and Critical Care (IRB 00010254-2018-032). According to French law, the patients and/or next of kin were informed about the inclusion of their anonymized data in the database, and none declined participation.

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This article is related to the commentary available at https://link.springer.com/article/10.1007/s12028-022-01566-4.

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de Courson, H., Proust-Lima, C., Tuaz, E. et al. Relationship Between Brain Tissue Oxygen and Near-Infrared Spectroscopy in Patients with Nontraumatic Subarachnoid Hemorrhage. Neurocrit Care 37, 620–628 (2022). https://doi.org/10.1007/s12028-022-01563-7

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