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The development of noninvasive, near infrared spectroscopy (NIRS) analysis of tissue hemoglobin saturation in vivo over the last decade has provided a new and dramatic tool for hemodynamic management, allowing early detection and correction of imbalances in oxygen delivery to the brain and vital organs.The theory and validity of NIRS, as well as its therapeutic applications, are discussed.
Tissue penetration and reaction to diverse physiologic and pharmacologic processes are documented, resulting in variations in oxygen supply and blood flow to the organs and brain as represented in regional hemoglobin oxygen saturation (rSO2).
The accuracy of rSO2 measurements is examined, as well as the clinical application of NIRS in cardiac surgery and critical care in adults, children, and babies.
Transcutaneous oximetry based on near infrared (NIR) diffuse reflectance spectroscopy has quickly become a standard of treatment.
While pulse oximetry measures arterial hemoglobin saturation, venous oximetry measures tissue hemoglobin saturation in capillary beds, which reflects O2 delivery and demand in the tissues.
This simple, noninvasive method is based on complicated and detailed chemical principles that have been improved over the years to deliver unique and useful insights about oxygen biology.
The use of nm wavelength NIR light for in vivo spectroscopic investigation of hemoglobin saturation is based on the fact that very few compounds in tissue absorb NIR light, allowing for deeper light penetration.
Chemical absorption of electromagnetic energy ranging from X-ray to infrared wavelengths.
To be accurate, a substance must be in a very pure form, free of impurities, unless the pollutants do not absorb the precise wavelengths of light.
Only metalloproteins containing porphyrin rings absorb much NIR light, and hemoglobin molar absorptivity at these overtone (harmonic) wavelengths is extremely low.
Although cytochrome enzymes absorb NIR light, their tissue content is an order of magnitude lower than that of hemoglobin.
Furthermore, myoglobin desaturation is restricted, allowing saturation tests to be hemoglobin specific.Because visible light cannot penetrate tissue very deep, the early machines assessed hemoglobin saturation in the blood only below the skin surface, although they were remarkably precise for their simplicity.
Over the last decade, near infrared spectroscopy (NIRS) has been widely utilized to monitor oxygen supply to the brain and spine in adults, children, and newborns after cardiac and vascular procedures.
It has been demonstrated to enhance outcomes and avert potentially disastrous effects from accidents such as cannula misplacement.
The use of NIRS to monitor both cerebral and somatic tissues in babies and children after cardiac surgery and in the intensive care unit (ICU) has gradually increased in recent years, adding considerably to hemodynamic control.
The accuracy of NIRS for measuring brain O2 supply has been confirmed by comparing it to levels of internal jugular vein hemoglobin saturation (SvO2) reported in independent investigations in adults, children, and newborns, as well as in animals.
When validating the accuracy of any cerebral oximeter, a number of factors must be considered, including the significant incidence of gross anatomical variability in the vascular anatomy of the brain, which necessitates placing the sensor on the same side of the head as the jugular vein that was sampled.
Compensation for skull and muscle is also required and was created based on empirical observations of indocyanine green dye injections in the internal and external carotid arteries, guaranteeing that cerebral regional oxygen content (rSO2) is specific for the brain.
Accuracy and precision are critical components of analytical procedures and are required for verifying any monitoring device, but they are not the same as target physiologic values.
While pulse oximetry monitors arterial blood saturation (SpO2) by measuring the pulse interval and has a goal value, tissue oximetry is a venous weighted measure that represents the arteriovenous (AV) difference and the adequacy of oxygen delivery.
Tissue oximetry gives a normal saturation range related to venous outflow that is patient specific and known to vary widely.
To comprehend the usefulness and accuracy of rSO2, keep in mind that it is venous weighted and so susceptible to all physiologic variables that impact oxygen availability.
The Global Somatic Oximetry Systems Market accounted for $XX Billion in 2022 and is anticipated to reach $XX Billion by 2030, registering a CAGR of XX% from 2024 to 2030.
Medtronic plc , a worldwide leader in healthcare technology, said today that the United States Food and Drug Administration (FDA) has awarded 510(k) approval for its INVOS 7100 cerebral/somatic oximetry system for children aged birth to 18.
The INVOS system detects vital signals to help pediatric physicians make time-critical choices about hemodynamic management, ventilation, and resuscitation for preterm babies, neonates, children, and other patients treated by pediatric clinicians.
For fragile pediatric patients, timing is crucial, and the INVOS 7100 system can warn doctors to changes in patient state before standard monitoring measures react.
The INVOS 7100 system can assist doctors in determining if intervention is required – a critical component of effective results.Furthermore, system regularly allows users to assess if they need to intervene sooner.
The INVOS near-infrared spectroscopy monitoring system is the clinical reference standard for regional oximetry and has already been certified for use in adult patients.
The INVOS 7100 system’s real-time assessments of tissue perfusion and oxygenation give early warnings of changes in perfusion before other vital sign readings.
This data may alert physicians when a patient’s condition deteriorates, giving them the important time required to treat neonates and young patients.
From RSV to complex heart conditions and beyond, clinicians face a plethora of time-critical conditions when treating some of the youngest patients in intensive care units.
They View this as a chance to give clinicians with technology that will assist improve outcomes for the most vulnerable populations, and Theyare excited about it.
