Relevance of depth resolution for cerebral blood flow monitoring by near-infrared spectroscopic bolus tracking during cardiopulmonary bypass Jens Steinbrink,

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Presentation transcript:

Relevance of depth resolution for cerebral blood flow monitoring by near-infrared spectroscopic bolus tracking during cardiopulmonary bypass Jens Steinbrink, PhD, Thomas Fischer, MD, Hermann Kuppe, MD, Roland Hetzer, MD, Kamil Uludag, PhD, Hellmuth Obrig, MD, Wolfgang M. Kuebler, MD The Journal of Thoracic and Cardiovascular Surgery Volume 132, Issue 5, Pages 1172-1178 (November 2006) DOI: 10.1016/j.jtcvs.2006.05.065 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Representative tracings of several intravenously administered indocyanine green boluses monitored by depth-resolved near-infrared spectroscopy in intracerebral (upper panel) and extracerebral (lower panel) compartments before (pre), during (CPB), and after (post) cardiopulmonary bypass in patient C. Note low variance of intracerebral versus extracerebral signal. ΔcICG, Change in indocyanine green concentration. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1172-1178DOI: (10.1016/j.jtcvs.2006.05.065) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Averaged intracerebral (black) and extracerebral (gray) tracer kinetics of intravenous indocyanine green boluses as monitored by depth-resolved near-infrared spectroscopy before (PRE), during (CPB), and after (POST) cardiopulmonary bypass in 4 patients. To account for large intersubject variations, range of y-axis is kept fixed for all three phases but is different for all 4 patients. Δμa, Change in absorption. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1172-1178DOI: (10.1016/j.jtcvs.2006.05.065) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Mean blood flow index (BFI) determined from multiple indocyanine green bolus curves before (pre) and after (post) cardiopulmonary bypass. Asterisks indicate significant changes according to Mann-Whitney U test in individual subjects. (A) In case of depth-resolved analysis, significant 1.5 ± 0.3 times (mean ± SD) increase in blood flow index was detected in 4 subjects. (B) By conventional analysis, no significant change in blood flow index was observed. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1172-1178DOI: (10.1016/j.jtcvs.2006.05.065) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Comparison of indocyanine green tracer kinetics detected by depth-resolved and conventional near-infrared spectroscopy. Representative tracings are derived from averaged bolus kinetics recorded in patient A after cardiopulmonary bypass. Normalized indocyanine green concentration is given for intracerebral (black) and extracerebral (gray) indocyanine green kinetics, as recorded by depth-resolved near-infrared spectroscopy, and a conventional signal curve as would be recorded by continuous-wave near-infrared spectroscopy without depth resolution (open triangles). ΔcICG, Change in indocyanine green concentration; a.u., arbitrary units. The Journal of Thoracic and Cardiovascular Surgery 2006 132, 1172-1178DOI: (10.1016/j.jtcvs.2006.05.065) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions