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Journal of Biomedical Optics

Brain oxymetry in the operating room: current status and future directions with particular regard to cytochrome oxidase
Author(s): Yasuyuki Kakihana; Akira Matsunaga; Tomotsugu Yasuda; Toru Imabayashi; Yuichi Kanmura; Mamoru Tamura
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Paper Abstract

Near-infrared spectroscopy (NIRS) is a cerebral monitoring method that noninvasively and continuously measures cerebral hemoglobin oxygenation and the redox state of cytochrome oxidase using highly tissue-permeable near-infrared light. This technique now has wide clinical application, and its usefulness in the measurement of cerebral hemoglobin oxygenation has been confirmed under global cerebral injury and/or hypoxemic hypoxia; however, regional cerebral infarction located far from the monitoring site may not be detected by NIRS. Furthermore, the specificity and accuracy of the measurement of the redox state of cytochrome oxidase remain controversial. We apply NIRS to both animal and clinical investigations. Based on these results, we discuss the significance of the measurement of cerebral hemoglobin oxygenation and cytochrome oxidase in vivo and in clinical medicine. Using our algorithm, cytochrome oxidase signals are unaffected by hemoglobin signals, even when hematocrit values change from 35 to 5% under cardiopulmonary bypass in a dog model. In the clinical study, cytochrome oxidase during surgery is likely to be a good (though not perfect) predictor of postoperative cerebral outcome. NIRS appears to be a promising technology, but additional investigations are required to establish its clinical efficacy and justify its routine use during operative and perioperative periods.

Paper Details

Date Published: 1 May 2008
PDF: 0 pages
J. Biomed. Opt. 13(3) 033001 doi: 10.1117/1.2940583
Published in: Journal of Biomedical Optics Volume 13, Issue 3
Show Author Affiliations
Yasuyuki Kakihana, Kagoshima Univ. (Japan)
Akira Matsunaga
Tomotsugu Yasuda, Kagoshima Univ. (Japan)
Toru Imabayashi, Kagoshima Univ. (Japan)
Yuichi Kanmura, Kagoshima Univ. (Japan)
Mamoru Tamura, Hokkaido Univ. (Japan)

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