Koopmans, A.G.M. (2021) Masimo O3™ regional near-infrared spectroscopy (NIRS) oximeter cannot validly detect changes in brain tissue oxygenation during intra-arterial thrombectomy (IAT) for acute ischemic stroke (AIS). thesis, Medicine.
Full text available on request.Abstract
Introduction: Intra-arterial thrombectomy (IAT) is a well-proven method to restore cerebral perfusion in patients suffering from acute ischemic stroke (AIS). Periprocedural blood pressure, cerebral blood flow and thereby oxygen delivery optimization is the key for good recovery after IAT. However, anesthetic blood pressure management during the IAT is not evidence based. Near infrared spectroscopy (NIRS), a validated, non-invasive, measure of regional (brain) tissue oxygenation (rSO2), has the potential to rationalize periprocedural blood pressure management. Before investigating this potential, it is necessary to determine if NIRS can validly detect brain tissue oxygenation changes during the IAT. Aim: To determine if the NIRS oximeter ‘Masimo O3™ Regional Oximeter System’ can validly detect brain tissue oxygenation changes during and after an IAT. Methods: In this prospective observational study, NIRS sensors were applied bilaterally to the temporal region of the head in 20 patients undergoing an IAT for AIS of the middle cerebral artery (MCA). Physiological variables and rSO2 were measured during the total procedure. The Wilcoxon signed ranks test was used to determine if rSO2 values differed between the ischemic and the non-ischemic brain hemisphere and to determine if rSO2 values before reperfusion were different from rSO2 values after reperfusion. Results: rSO2 values were not significantly different in the ischemic hemisphere versus the non-ischemic hemisphere at the start of the procedure (Z = -0.443, p = 0.658), before reperfusion (Z = -0.505, p = 0.614), after reperfusion (Z = -1.787, p = 0.074), at the end of the procedure (Z = -1.128, p = 0.259) and during the total procedure (Z = -1.028, p = 0.304). rSO2 values before reperfusion were not significantly different from the values after reperfusion in both the ischemic (Z = -1.294, p = 0,196) and the non-ischemic hemisphere (Z = -0.545, p = 0.585). Conclusion: We cannot conclude that the NIRS oximeter ‘Masimo O3™’ can validly detect changes in brain tissue oxygenation during an IAT.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Absalom, Prof. dr. A.R. and Sahinovic, Dr. M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 24 Dec 2021 10:30 |
| Last Modified: | 24 Dec 2021 10:30 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2909 |
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