Skip to main content
Top
Published in: Journal of Clinical Monitoring and Computing 5/2017

01-10-2017 | Original Research

Transcutaneous near-infrared spectroscopy for monitoring spinal cord ischemia: an experimental study in swine

Authors: Koichi Suehiro, Tomoharu Funao, Yohei Fujimoto, Akira Mukai, Mitsuyo Nakamura, Kiyonobu Nishikawa

Published in: Journal of Clinical Monitoring and Computing | Issue 5/2017

Login to get access

Abstract

We aimed to assess the ability of near-infrared spectroscopy (NIRS) to detect spinal cord ischemia, and to evaluate changes in regional oxygen saturation (rSO2) following recovery of spinal cord circulation and cerebrospinal fluid drainage. Four 12-month-old female swine weighing 28.7–29.5 kg were acquired for this study. NIRS probes were placed along the midline of the upper (T6/7) and lower (T9/T10) thoracic vertebrae. The thoracic aorta was clamped distal of the left subclavian artery to induce spinal ischemia. Aortic cross-clamping was maintained for 30 min. Fifteen minutes after aortic de-clamping, the cerebrospinal fluid drainage catheter was opened to air, and cerebrospinal fluid drainage was initiated. Following aortic clamping, rSO2 in both upper and lower regions of the spinal cord decreased by 15 % within 5 min and by 20 % within 10 min (relative change). After aortic de-clamping, rSO2 values in both regions returned to baseline within 5 min. No changes in rSO2 in either the upper or lower vertebrae were observed following initiation of cerebrospinal fluid drainage. Histological analysis revealed that ischemic changes had occurred in all spinal levels. NIRS may be used to detect decreases in and recovery of spinal cord circulation following aortic clamping and de-clamping, whereas it may not reflect minor changes in spinal cord circulation due to cerebrospinal fluid drainage. Further clinical studies are required to investigate the potential for NIRS as an index of spinal cord circulation.
Literature
1.
go back to reference Kouchoukos NT, Masetti P, Rokkas CK, Murphy SF, Blackstone EH. Safety and efficacy of hypothermic cardiopulmonary bypass and circulatory arrest for operations on the descending thoracic and thoracoabdominal aorta. Ann Thorac Surg. 2001;72:699–707.CrossRefPubMed Kouchoukos NT, Masetti P, Rokkas CK, Murphy SF, Blackstone EH. Safety and efficacy of hypothermic cardiopulmonary bypass and circulatory arrest for operations on the descending thoracic and thoracoabdominal aorta. Ann Thorac Surg. 2001;72:699–707.CrossRefPubMed
2.
go back to reference Estrera AL, Miller CC III, Huynh TT, Porat E, Safi HJ. Neurologic outcome after thoracic and thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2001;72:1225–30.CrossRefPubMed Estrera AL, Miller CC III, Huynh TT, Porat E, Safi HJ. Neurologic outcome after thoracic and thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2001;72:1225–30.CrossRefPubMed
3.
go back to reference Coselli JS, LeMaire SA, Conklin LD, Koksoy C, Schmittling ZC. Morbidity and mortality after extent II thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2002;73:1107–15.CrossRefPubMed Coselli JS, LeMaire SA, Conklin LD, Koksoy C, Schmittling ZC. Morbidity and mortality after extent II thoracoabdominal aortic aneurysm repair. Ann Thorac Surg. 2002;73:1107–15.CrossRefPubMed
4.
go back to reference Etz CD, von Aspern K, Gudehus S, Luehr M, Girrbach FF, Ender J, Borger M, Mohr FW. Near-infrared spectroscopy monitoring of the collateral network prior to, during, and after thoracoabdominal aortic repair: a pilot study. Eur J Vasc Endovasc Surg. 2013;46:651–6.CrossRefPubMed Etz CD, von Aspern K, Gudehus S, Luehr M, Girrbach FF, Ender J, Borger M, Mohr FW. Near-infrared spectroscopy monitoring of the collateral network prior to, during, and after thoracoabdominal aortic repair: a pilot study. Eur J Vasc Endovasc Surg. 2013;46:651–6.CrossRefPubMed
5.
go back to reference Reuter DG, Tacker WA Jr, Badylak SF, Voorhees WD 3rd, Konrad PE. Correlation of motor-evoked potential response to ischemic spinal cord damage. J Thorac Cardiovasc Surg. 1992;104:262–72.PubMed Reuter DG, Tacker WA Jr, Badylak SF, Voorhees WD 3rd, Konrad PE. Correlation of motor-evoked potential response to ischemic spinal cord damage. J Thorac Cardiovasc Surg. 1992;104:262–72.PubMed
6.
go back to reference Schepens MA, Boezeman EH, Hamerlijnck RP, ter Beek H, Vermeulen FE. Somatosensory evoked potentials during exclusion and reperfusion of critical aortic segments in thoracoabdominal aortic aneurysm surgery. J Card Surg. 1994;9:692–702.CrossRefPubMed Schepens MA, Boezeman EH, Hamerlijnck RP, ter Beek H, Vermeulen FE. Somatosensory evoked potentials during exclusion and reperfusion of critical aortic segments in thoracoabdominal aortic aneurysm surgery. J Card Surg. 1994;9:692–702.CrossRefPubMed
7.
go back to reference Crawford ES, Mizrahi EM, Hess KR, Coselli JS, Safi HJ, Patel VM. The impact of distal aortic perfusion and somatosensory evoked potential monitoring on prevention of paraplegia after aortic aneurysm operation. J Thorac Cardiovasc Surg. 1988;95:357–67.PubMed Crawford ES, Mizrahi EM, Hess KR, Coselli JS, Safi HJ, Patel VM. The impact of distal aortic perfusion and somatosensory evoked potential monitoring on prevention of paraplegia after aortic aneurysm operation. J Thorac Cardiovasc Surg. 1988;95:357–67.PubMed
8.
go back to reference Harilall Y, Adam JK, Biccard BM, Reddi A. The effect of optimising cerebral tissue oxygen saturation on markers of neurological injury during coronary artery bypass graft surgery. Heart Lung Circ. 2014;23:68–74.CrossRefPubMed Harilall Y, Adam JK, Biccard BM, Reddi A. The effect of optimising cerebral tissue oxygen saturation on markers of neurological injury during coronary artery bypass graft surgery. Heart Lung Circ. 2014;23:68–74.CrossRefPubMed
9.
go back to reference Zheng F, Sheinberg R, Yee MS, Ono M, Zheng Y, Hogue CW. Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg. 2013;116:663–76.CrossRefPubMed Zheng F, Sheinberg R, Yee MS, Ono M, Zheng Y, Hogue CW. Cerebral near-infrared spectroscopy monitoring and neurologic outcomes in adult cardiac surgery patients: a systematic review. Anesth Analg. 2013;116:663–76.CrossRefPubMed
10.
go back to reference Daubeney PE, Smith DC, Pilkington SN, Lamb RK, Monro JL, Tsang VT, Livesey SA, Webber SA. Cerebral oxygenation during paediatric cardiac surgery: identification of vulnerable periods using near infrared spectroscopy. Eur J Cardiothorac Surg. 1998;13:370–7.CrossRefPubMed Daubeney PE, Smith DC, Pilkington SN, Lamb RK, Monro JL, Tsang VT, Livesey SA, Webber SA. Cerebral oxygenation during paediatric cardiac surgery: identification of vulnerable periods using near infrared spectroscopy. Eur J Cardiothorac Surg. 1998;13:370–7.CrossRefPubMed
11.
go back to reference Suehiro K, Okutai R. Duration of cerebral desaturation time during single-lung ventilation correlates with mini mental state examination score. J Anesth. 2011;25:345–9.CrossRefPubMed Suehiro K, Okutai R. Duration of cerebral desaturation time during single-lung ventilation correlates with mini mental state examination score. J Anesth. 2011;25:345–9.CrossRefPubMed
12.
go back to reference Suehiro K, Okutai R. Cerebral desaturation during single-lung ventilation is negatively correlated with preoperative respiratory functions. J Cardiothorac Vasc Anesth. 2011;25:127–30.CrossRefPubMed Suehiro K, Okutai R. Cerebral desaturation during single-lung ventilation is negatively correlated with preoperative respiratory functions. J Cardiothorac Vasc Anesth. 2011;25:127–30.CrossRefPubMed
13.
go back to reference Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I, Cleland A, Schaefer B, Irwin B, Fox S. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg. 2007;104:51–8.CrossRefPubMed Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I, Cleland A, Schaefer B, Irwin B, Fox S. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg. 2007;104:51–8.CrossRefPubMed
14.
go back to reference Hayatsu Y, Kawamoto S, Matsunaga T, Haga Y, Saiki Y. Real-time monitoring of spinal cord blood flow with a novel sensor mounted on a cerebrospinal fluid drainage catheter in an animal model. J Thorac Cardiovasc Surg. 2014;148:1726–31.CrossRefPubMed Hayatsu Y, Kawamoto S, Matsunaga T, Haga Y, Saiki Y. Real-time monitoring of spinal cord blood flow with a novel sensor mounted on a cerebrospinal fluid drainage catheter in an animal model. J Thorac Cardiovasc Surg. 2014;148:1726–31.CrossRefPubMed
15.
go back to reference LeMaire SA, Ochoa LN, Conklin LD, Widman RA, Clubb FJ Jr, Undar A, Schmittling ZC, Wang XL, Fraser CD Jr, Coselli JS. Transcutaneous near-infrared spectroscopy for detection of regional spinal ischemia during intercostal artery ligation: preliminary experimental results. J Thorac Cardiovasc Surg. 2006;132:1150–5.CrossRefPubMed LeMaire SA, Ochoa LN, Conklin LD, Widman RA, Clubb FJ Jr, Undar A, Schmittling ZC, Wang XL, Fraser CD Jr, Coselli JS. Transcutaneous near-infrared spectroscopy for detection of regional spinal ischemia during intercostal artery ligation: preliminary experimental results. J Thorac Cardiovasc Surg. 2006;132:1150–5.CrossRefPubMed
16.
go back to reference Macnab AJ, Gagnon RE, Gagnon FA. Near infrared spectroscopy for intraoperative monitoring of the spinal cord. Spine (Phila Pa 1976). 2002;27(1):17–20.CrossRef Macnab AJ, Gagnon RE, Gagnon FA. Near infrared spectroscopy for intraoperative monitoring of the spinal cord. Spine (Phila Pa 1976). 2002;27(1):17–20.CrossRef
17.
go back to reference Demir A, Erdemli O, Unal U, Tasoglu I. Near-infrared spectroscopy monitoring of the spinal cord during type B aortic dissection surgery. J Card Surg. 2013;28:291–4.CrossRefPubMed Demir A, Erdemli O, Unal U, Tasoglu I. Near-infrared spectroscopy monitoring of the spinal cord during type B aortic dissection surgery. J Card Surg. 2013;28:291–4.CrossRefPubMed
18.
go back to reference Jacobs MJ, Meylaerts SA, de Haan P, de Mol BA, Kalkman CJ. Strategies to prevent neurologic deficit based on motor-evoked potentials in type I and II thoracoabdominal aortic aneurysm repair. J Vasc Surg. 1999;29:48–57.CrossRefPubMed Jacobs MJ, Meylaerts SA, de Haan P, de Mol BA, Kalkman CJ. Strategies to prevent neurologic deficit based on motor-evoked potentials in type I and II thoracoabdominal aortic aneurysm repair. J Vasc Surg. 1999;29:48–57.CrossRefPubMed
19.
go back to reference Jacobs MJ, Mess WH. The role of evoked potential monitoring in operative management of type I and type II thoracoabdominal aortic aneurysms. Semin Thorac Cardiovasc Surg. 2003;15:353–64.CrossRefPubMed Jacobs MJ, Mess WH. The role of evoked potential monitoring in operative management of type I and type II thoracoabdominal aortic aneurysms. Semin Thorac Cardiovasc Surg. 2003;15:353–64.CrossRefPubMed
20.
go back to reference Jacobs MJ, Meylaerts SA, de Haan P, de Mol BA, Kalkman CJ. Assessment of spinal cord ischemia by means of evoked potential monitoring during thoracoabdominal aortic surgery. Semin Vasc Surg. 2000;13:299–307.PubMed Jacobs MJ, Meylaerts SA, de Haan P, de Mol BA, Kalkman CJ. Assessment of spinal cord ischemia by means of evoked potential monitoring during thoracoabdominal aortic surgery. Semin Vasc Surg. 2000;13:299–307.PubMed
21.
go back to reference Cho H, Nemoto EM, Yonas H, Balzer J, Sclabassi RJ. Cerebral monitoring by means of oximetry and somatosensory evoked potentials during carotid endarterectomy. J Neurosurg. 1998;89:533–8.CrossRefPubMed Cho H, Nemoto EM, Yonas H, Balzer J, Sclabassi RJ. Cerebral monitoring by means of oximetry and somatosensory evoked potentials during carotid endarterectomy. J Neurosurg. 1998;89:533–8.CrossRefPubMed
Metadata
Title
Transcutaneous near-infrared spectroscopy for monitoring spinal cord ischemia: an experimental study in swine
Authors
Koichi Suehiro
Tomoharu Funao
Yohei Fujimoto
Akira Mukai
Mitsuyo Nakamura
Kiyonobu Nishikawa
Publication date
01-10-2017
Publisher
Springer Netherlands
Published in
Journal of Clinical Monitoring and Computing / Issue 5/2017
Print ISSN: 1387-1307
Electronic ISSN: 1573-2614
DOI
https://doi.org/10.1007/s10877-016-9931-8

Other articles of this Issue 5/2017

Journal of Clinical Monitoring and Computing 5/2017 Go to the issue