J Clin Monit Comput - Comparison of two different generations of NIRS devices and transducers in healthy volunteers and ICU patients.

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Resumo

The purpose of this study is to compare Near Infrared Spectroscopy (NIRS) thenar eminence parameters obtained with 2 different devices from the same manufacturer (InSpectra Models 325 and 650, Hutchinson Tech, Min USA), and 2 different probes (15 vs. 25 mm spacing), in healthy volunteers (HV) and ICU patients. Prospective, observational study in ICU setting. Simultaneous, cross over NIRS inter-device comparison and comparison between different probes (25 vs. 15 mm spacing) were done at baseline and during vascular occlusion tests (VOTs). Forty patients (19 septic shock, 21 trauma), and 29 HV were included. NIRS inter-device comparison showed similar baseline StO(2) values in HV and patients. The VOT result were significantly different for minimal StO(2) value reached during VOT (StO(2min)) (intraclass concordance coefficient (ICC) = 0.18), the occlusion slope (ICC = 0.16) and the reperfusion slope (StO(2reperf)) (ICC = 0.26). The probe comparison was also significantly different for VOT parameters (StO(2min) (ICC = 0.43), occlusion (ICC = 0.50) and StO(2reperf) (ICC = 0.48). The low concordance, poor agreement and large bias (ICC and Bland & Altman) observed, were related both to the device used and the probe spacing. StO(2) data obtained with NIRS model 650 and 15 mm probe differ from values obtained with the previous device (325 and probe spacing 25 or 15 mm). This difference is not related to the population tested, but to the device and probe spacing. As a consequence, despite similar trends for variations between HV and patients during VOT, threshold and predictive values for outcome should be revisited with the new device before the acceptance for routine clinical use.

Resumo Limpo

purpos studi compar near infrar spectroscopi nir thenar emin paramet obtain differ devic manufactur inspectra model hutchinson tech min usa differ probe vs mm space healthi volunt hv icu patient prospect observ studi icu set simultan cross nir interdevic comparison comparison differ probe vs mm space done baselin vascular occlus test vot forti patient septic shock trauma hv includ nir interdevic comparison show similar baselin sto valu hv patient vot result signific differ minim sto valu reach vot stomin intraclass concord coeffici icc occlus slope icc reperfus slope storeperf icc probe comparison also signific differ vot paramet stomin icc occlus icc storeperf icc low concord poor agreement larg bias icc bland altman observ relat devic use probe space sto data obtain nir model mm probe differ valu obtain previous devic probe space mm differ relat popul test devic probe space consequ despit similar trend variat hv patient vot threshold predict valu outcom revisit new devic accept routin clinic use

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