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Anatomical and physiological variables influencing measurement of regional cerebral oxygen saturation by near infrared spectroscopy using the Sensmart Model X-100TM

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Abstract

The Sensmart Model X-100 (Nonin Medical Inc, Plymouth, MN, USA) is a relatively new device that possesses two sets of emitters and detectors and uses near infrared spectroscopy (NIRS) to measure regional cerebral oxygen saturation (rSO2). The value of rSO2 obtained by other NIRS devices is affected by physiological and anatomical variables such as hemoglobin concentration, area of cerebrospinal fluid (CSF) layer and skull thickness. The effects of these variables have not yet been determined in measurement of rSO2 by Sensmart Model X-100. We examined the effects of area of CSF, hemoglobin concentration, and skull thickness on the values of rSO2 measured by Sensmart Model X-100 and tissue oxygen index (TOI) measured by NIRO-200NX (Hamamatsu Photonix, Hamamatsu, Japan). Forty neurosurgical, cardiac and vascular surgical patients who underwent preoperative computed tomographic (CT) scan of the brain were enrolled in this study. Regional cerebral oxygen saturation (rSO2) at the forehead was measured sequentially by NIRO-200NX and by Sensmart Model X-100. Simultaneously, mean arterial pressure, hemoglobin concentration, and partial pressure of carbon dioxide in arterial blood (PaCO2) were measured. To evaluate the effects of anatomical factors on rSO2, we measured skull thickness and area of CSF layer using CT images of the brain. Multiple regression analysis was used to examine the relationships between the rSO2 values and anatomical and physiological factors. The area of the CSF layer and hemoglobin concentration had significant associations with rSO2 measured by the Sensmart Model X-100, whereas none of the studied variables was significantly associated with TOI. The measurement of rSO2 by Sensmart Model X-100 is not affected by the skull thickness of patients. Area of the CSF layer and hemoglobin concentration may be the main biases in measurement of rSO2 by Sensmart Model X-100.

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Data availability

Data are available by requesting the corresponding author (MS).

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Acknowledgements

The authors thank Eiji Okada, Professor of Keio University, Division of Science, for assistance in preparation of the manuscript.

Funding

This study was funded by only departmental sources.

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Authors and Affiliations

  1. Department of Anesthesiology, Musashikosugi Hospital, Nippon Medical School, 1-396 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8533, Japan

    Yuichi Tanaka, Manzo Suzuki & Hiroyasu Bito

  2. Department of Anesthesiology, National Cardiovascular Center, Suita, Osaka, Japan

    Kenji Yoshitani

  3. Department of Anesthesiology, Nippon Medical School, Tokyo, Japan

    Atsuhiro Sakamoto

Authors
  1. Yuichi Tanaka
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  2. Manzo Suzuki
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  3. Kenji Yoshitani
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  4. Atsuhiro Sakamoto
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  5. Hiroyasu Bito
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Contributions

YT conducted the study. MS analyzed the data and prepared the manuscript. KY and HB instructed the study and writing of the manuscript. AS instructed the study.

Corresponding author

Correspondence to Manzo Suzuki.

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The authors have no conflicts of interest.

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The Ethics Committee of the National CardioVascular Center, Suita, Osaka, Japan, approved this study.

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Written informed consent was obtained from each patient.

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Tanaka, Y., Suzuki, M., Yoshitani, K. et al. Anatomical and physiological variables influencing measurement of regional cerebral oxygen saturation by near infrared spectroscopy using the Sensmart Model X-100TM. J Clin Monit Comput 35, 1063–1068 (2021). https://doi.org/10.1007/s10877-020-00567-y

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  • DOI: https://doi.org/10.1007/s10877-020-00567-y

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