Estimation of Jugular Venous O2 Saturation from Cerebral Oximetry or Arterial O2 Saturation during Isocapnic Hypoxia
Objective.Near-infrared spectroscopy (NIRS) has the potential forproviding valuable information about oxygen delivery to the brain. However,questions have been raised about the accuracy of these measurements. Thisstudy was undertaken to compare noninvasive cerebral saturation measurementsto jugular venous saturation under conditions of hypoxia and hypercapnia.Methods.Data was obtain on forty-two subjects. Cerebral oxygenationwas measured with a Somanetics INVOS 4100-SSA placed on the forehead of thesubjects. PETCO2 was controlled to approximately 2 and 7 mmHg aboveresting values and PETO2 was controlled to 80, 45, 60 and 41 mmHgconsecutively for four of five minutes each. Internal jugular blood gasmeasurements were made via a retrograde catheter. Results.Both thecerebral oximetry measured saturation (rSO2) and the jugular venoussaturation (Sj\(\bar v \)O2) were significantly increasedby increasing the PETCO2 at all levels of hypoxia. The increase inthe rSO2 was less than the increase inSj\(\bar v\)O2. The rSO2 had a bias of 5.2%and a precision of 10.7% compared to the measuredSj\(\bar v\)O2. Discussion.Cerebral oxygensaturation measured by cerebral oximetry compares well to the measuredSj\(\bar v\)O2 in normal subjects, despite multiplephysiological reasons for differences. The closer relationship ofSj\(\bar v\)O2 to rSO2 than SaO2under the conditions of these experiments indicates that the measurementreflects primarily intracranial saturation. However, outcome studies underclinical conditions are needed to determine the clinical utility of cerebraloximetry.
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- 3.Connors AF, Speroff T, Dawson NV, Thomas C, Harrell FE, Wagner D, Desbiens N, Goldman, Wu AW, Califf RM, Fulkerson WJ, Vidaillet H, Broste S, Bellamy P, Lynn J, Knaus WA. The effectiveness of right heart catheterization in the initial care of critically ill patients. JAMA 1996; 276: 889-897PubMedCrossRefGoogle Scholar
- 4.Cui W, Kumar C, Chance B. Experimental study of migration depth for photons measured at sample surface. Proc SPIE 1991; 1431: 180-191Google Scholar
- 17.Liu H, Boas DAZY, Yodh AG, Chance B. A simplified approach to characterize optical properties and blood oxygenation in tissue using continuous near infrared light. Proc SPIE 1995; 2389: 496-502Google Scholar
- 18.Matcher SJ, Kirkpatrick P, Nahid K, Cope M, Delphy DT. Absolute quantification methods in tissue near infrared spectroscopy. Proc SPIE 1995; 2389: 486-495Google Scholar
- 21.Mchedlishvili GI. Arterial behavior and blood circulation in the brain. New York: Consultants Bureau, 1986: 42-95Google Scholar
- 22.Möller JT, Johannessen NW, Espersen K, Ravlo O, Pedersen BD, Jensen, PF, Rasmussen NH, Rasmussen LS, Pedersen T, Cooper JB et al. Randomized evaluation of pulse oximetry in 20,802 patients: II. Perioperative events and postoperative complications. Anesthesiology 1993; 78: 445-453PubMedCrossRefGoogle Scholar
- 24.Patterson MS, Schwartz E, Wilson BC. Quantitative reflectance spectrophotometry for the non-invasive measurement of photosensitizer concentration in tissue during photodynamic therapy. Proc SPIE 1989; 1065: 115-122Google Scholar
- 27.Samra SK, Stanley JC, Zelenock GB, Dorje P. An assessment of contributions made by extracranial tissues during cerebral oximetry. J Neurosurg Anesth 1999; 11: 1-5Google Scholar
- 34.Yao FSF, Tseng CC, Boyd WC, Shukla K, Hartman GS. Cognitive dysfunction following cardiac surgery is associated with cerebral oxygen desaturation. Anesthesiology 1999; 91: A73Google Scholar
- 35.Yao FSF, Tseng CC, Braverman JM, Levin SK, Illner P. Cerebral oxygen desaturation is associated with prolonged lengths of stay in the Intensive Care Unit (ICU) and hospital. Anesthesiology 1999; 91: A123Google Scholar