Journal Article Research Support, Non-U.S. Gov't Epublish 7 citations
PubMed: 38486211 DOI: 10.1186/s13054-024-04859-6
Prognostic value of near-infrared spectroscopy regional oxygen saturation and cerebrovascular reactivity index in acute traumatic neural injury: a CAnadian High-Resolution Traumatic Brain Injury (CAHR-TBI) Cohort Study.
Crit Care 28(1):78
Authors: Alwyn Gomez, Logan Froese, Donald Griesdale, Eric P Thelin, Rahul Raj, Levi van Iperenburg, Jeanette Tas, Marcel Aries, Kevin Y Stein, Clare Gallagher, Francis Bernard, Andreas H Kramer, Frederick A Zeiler
Affiliations
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
- Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Department of Biomedical Engineering, Price Faculty of Engineering, University of Manitoba, Winnipeg, MB, Canada.
- Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC, Canada.
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
- Department of Neurosurgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
- Department of Intensive Care, Maastricht University Medical Center+, Maastricht, The Netherlands. School of Mental Health and Neurosciences, University Maastricht, Maastricht, The Netherlands.
- Department of Intensive Care, Maastricht University Medical Center+, Maastricht, The Netherlands.
- School of Mental Health and Neurosciences, University Maastricht, Maastricht, The Netherlands.
- Section of Neurosurgery, Department of Clinical Neurosciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada.
- Section of Critical Care, Department of Medicine, University of Montreal, Montreal, QC, Canada.
- Department of Critical Care Medicine, University of Calgary, Calgary, AB, Canada.
- Section of Neurosurgery, Department of Surgery, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
- Centre on Aging, University of Manitoba, Winnipeg, Canada.
- Division of Anaesthesia, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
Abstract
BACKGROUND
Near-infrared spectroscopy regional cerebral oxygen saturation (rSO) has gained interest as a raw parameter and as a basis for measuring cerebrovascular reactivity (CVR) due to its noninvasive nature and high spatial resolution. However, the prognostic utility of these parameters has not yet been determined. This study aimed to identify threshold values of rSO and rSO-based CVR at which outcomes worsened following traumatic brain injury (TBI).
METHODS
A retrospective multi-institutional cohort study was performed. The cohort included TBI patients treated in four adult intensive care units (ICU). The cerebral oxygen indices, COx (using rSO and cerebral perfusion pressure) as well as COx_a (using rSO and arterial blood pressure) were calculated for each patient. Grand mean thresholds along with exposure-based thresholds were determined utilizing sequential chi-squared analysis and univariate logistic regression, respectively.
RESULTS
In the cohort of 129 patients, there was no identifiable threshold for raw rSO at which outcomes were found to worsen. For both COx and COx_a, an optimal grand mean threshold value of 0.2 was identified for both survival and favorable outcomes, while percent time above - 0.05 was uniformly found to have the best discriminative value.
CONCLUSIONS
In this multi-institutional cohort study, raw rSOwas found to contain no significant prognostic information. However, rSO-based indices of CVR, COx and COx_a, were found to have a uniform grand mean threshold of 0.2 and exposure-based threshold of - 0.05, above which clinical outcomes markedly worsened. This study lays the groundwork to transition to less invasive means of continuously measuring CVR.
MeSH
Intensive Care Units, Cohort Studies, Spectroscopy, Near-Infrared, Brain Injuries, Traumatic, Oxygen Saturation
Cited by
- Optical approaches for neurocritical care: Toward non-invasive recording of cerebral physiology in acute brain injury. Neurotherapeutics, 2025
- Commercial NIRS May Not Detect Hemispheric Regional Disparity in Continuously Measured COx/COx-a: An Exploratory Healthy and Cranial Trauma Time-Series Analysis. Bioengineering (Basel), 2025
- Critical thresholds of long-pressure reactivity index and impact of intracranial pressure monitoring methods in traumatic brain injury. Crit Care, 2024
- The association of acute and chronic phase cerebrovascular reactivity with patient reported quality of life following moderate-to-severe traumatic brain injury. Sci Rep, 2024