Noninvasive Optical Quantification of Cerebral Venous Oxygen Saturation in Humans

Jennifer M. Lynch, Erin M. Buckley, Peter J. Schwab, David R. Busch, Brian D. Hanna, Mary E. Putt, Daniel J. Licht, Arjun G. Yodh

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Rationale and Objectives: Cerebral oxygen extraction, defined as the difference between arterial and venous oxygen saturations (SaO2 and SvO2), is a critical parameter for managing intensive care patients at risk for neurological collapse. Although quantification of SaO2 is easily performed with pulse oximetry or moderately invasive arterial blood draws in peripheral vessels, cerebral SvO2 is frequently not monitored because of the invasiveness and risk associated with obtaining jugular bulb or super vena cava (SVC) blood samples. Materials and Methods: In this study, near-infrared spectroscopy (NIRS) was used to noninvasively measure cerebral SvO2 in anesthetized and mechanically ventilated pediatric patients (n = 10). To quantify SvO2, the NIRS signal component that fluctuates at the respiration frequency is isolated. This respiratory component is dominated by the venous portion of the interrogated vasculature. The NIRS measurements of SvO2 were validated against the clinical gold standard: invasively measured oxygen saturations from SVC blood samples. This technique was also applied in healthy volunteers (n = 5) without mechanical ventilation to illustrate its potential for use in healthy populations with natural airways. Results: Ten pediatric patients with pulmonary hypertension were studied. In these patients, SvO2 in the SVC exhibited good agreement with NIRS-measured SvO2 (R2 = 0.80, P =.001, slope = 1.16 ± 0.48). Furthermore, in the healthy adult volunteers, mean (standard deviation) NIRS-measured SvO2 was 79.4 (6.8)%. This value is in good agreement with the expected average central venous saturation reported in literature. Conclusion: Respiration frequency-selected NIRS can noninvasively quantify cerebral SvO2. This bedside technique can be used to help assess brain health in neurologically unstable patients.

Original languageEnglish (US)
Pages (from-to)162-167
Number of pages6
JournalAcademic radiology
Volume21
Issue number2
DOIs
StatePublished - Feb 1 2014

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Keywords

  • Cerebral venous oxygenation
  • Near-infrared spectroscopy
  • Noninvasive
  • Pediatrics
  • Validation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Lynch, J. M., Buckley, E. M., Schwab, P. J., Busch, D. R., Hanna, B. D., Putt, M. E., Licht, D. J., & Yodh, A. G. (2014). Noninvasive Optical Quantification of Cerebral Venous Oxygen Saturation in Humans. Academic radiology, 21(2), 162-167. https://doi.org/10.1016/j.acra.2013.10.013