TECH CORNER
Application Parameters Evidence Comments
Hematoma detection Based on Optical Density- , a
measure of light absorption by the
tissues
In single center studies of
adults and pediatric trauma
patients, NIRS with 4-10 points
of detection can be used as an
adjunct to CT head
Can be used as a screening
device in minor trauma.
Portable hand-held devices
are commercially available
but not specific; and cannot
be used in lieu of CT head
NIRS and perfusion in TBI, and
SAH
Relative CBF NIRS and CTP-variable
correlation in small studies
NIRS and Xenon CT have
variable correlation in small
studies
Trends rather than absolute
values might help but more
studies are needed
NIRS and ICP rSO2 No clear correlation in small
studies
More studies are needed
NIRS and carotid endarterectomy
(CEA)
rSO2 Multiple studies, largest with
n=594 reported a cut-off
between 12-20% decrease from
baseline rSO2 can be used as
a reliable threshold for brain
ischemia during ICA clamping
Can be used as an adjunct to
EEG or SSEP during CEA
NIRS and vasospasm rSO2 Small observational studies,
episodes of angiographic
vasospasm may be related to
reduction in rSO2
More data is needed
Table 1: Applications of NIRS in Neurocritical Care (1)(5)(2)
References:
1. Weigl W, Milej D, Janusek D, et al.: Application of optical
methods in the monitoring of traumatic brain injury: A
review. J Cereb Blood Flow Metab 2016; 36:1825–1843
2. Cyrous A, O’Neal B, Freeman WD: New approaches to
bedside monitoring in stroke. Expert Rev Neurother 2012;
12:915–928
3. Oximetry AT: Direct Accuracy Performance Comparison of
Cerebral Oximeter Devices. 2011;
4. Zheng F, Sheinberg R, Yee M-S, et al.: Cerebral Near-Infrared
Spectroscopy Monitoring and Neurologic Outcomes in Adult
Cardiac Surgery Patients. Anesth Analg 2013; 116:663–676
5. Nielsen HB: Systematic review of near-infrared spectroscopy
determined cerebral oxygenation during non-cardiac surgery.
Front Physiol 2014; 5:93
6. Murkin JM, Arango M: Near-infrared spectroscopy as an index
of brain and tissue oxygenation. Br J Anaesth 2009; 103:i3–i13
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