J Clin Monit Comput - Peripheral tissue oximetry: comparing three commercial near-infrared spectroscopy oximeters on the forearm.


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Estimation of regional tissue oxygenation (rStO2) by near infrared spectroscopy enables non-invasive end-organ oxygen balance monitoring and could be a valuable tool in intensive care. However, the diverse absolute values and dynamics of different devices, and overall poor repeatability of measurements are a problem. The aim of the present study is to test the hypothesis that INVOS 5100C, FORE-SIGHT and NONIN EQUANOX 7600 have similar properties concerning absolute values, repeatability, and sensitivity to changes in rStO2. To test repeatability the sensors were repositioned 20 times during hemodynamic steady state on the adult forearm. Afterwards six vascular occlusions by inflation of an upper arm cuff were done to achieve low oxygenation in the forearm. Absolute values were compared by repeated-measures ANOVA, repeatability was estimated by the within-subject standard deviation, Sw, and response to changing oxygenation by the down slope of rStO2 during vascular occlusion in the respective arm. 10 healthy adults, 21-29 years old, with double skinfolds on the forearm less than 10 mm participated. The median rStO2 was 70.7% (interquartile range (IQR) 7.7%), 68.4% (IQR 8.4%), and 64.6% (IQR 4.8) with INVOS, NONIN, and FORE-SIGHT, respectively, the median rate of decline was 13.2%/min (IQR 9.6), 22.8 %/min (IQR 18.0), and 10.8%/min (IQR 6.0), and the same-site repeatability was 2.9% (95% CI 2.4-3.3), 4.6% (CI 3.9-5.3), and 2.0% (CI 1.7-2.3). INVOS gave significantly higher steady state values than FORE-SIGHT, and NONIN had the steepest decline in rStO2, but the poorest repeatability. Two measures of signal-to-noise were similar among devices. This suggests that good repeatability comes at the expense of low sensitivity to changes in oxygenation. Values of rStO2 on the forearm from INVOS, NONIN and FORE-SIGTH cannot be used interchangeably.

Resumo Limpo

estim region tissu oxygen rsto near infrar spectroscopi enabl noninvas endorgan oxygen balanc monitor valuabl tool intens care howev divers absolut valu dynam differ devic overal poor repeat measur problem aim present studi test hypothesi invo c foresight nonin equanox similar properti concern absolut valu repeat sensit chang rsto test repeat sensor reposit time hemodynam steadi state adult forearm afterward six vascular occlus inflat upper arm cuff done achiev low oxygen forearm absolut valu compar repeatedmeasur anova repeat estim withinsubject standard deviat sw respons chang oxygen slope rsto vascular occlus respect arm healthi adult year old doubl skinfold forearm less mm particip median rsto interquartil rang iqr iqr iqr invo nonin foresight respect median rate declin min iqr min iqr min iqr samesit repeat ci ci ci invo gave signific higher steadi state valu foresight nonin steepest declin rsto poorest repeat two measur signaltonois similar among devic suggest good repeat come expens low sensit chang oxygen valu rsto forearm invo nonin foresigth use interchang

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