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Measurement of cerebral blood flow during cardiopulmonary bypass with near-infrared spectroscopy

Measurement of cerebral blood flow during cardiopulmonary bypass with near-infrared spectroscopy
Measurement of cerebral blood flow during cardiopulmonary bypass with near-infrared spectroscopy

Objective: A novel noninvasive method for repeatedly measuring cerebral blood flow during cardiopulmonary bypass by near-infrared spectroscopy is described. The reproducibility of the method is investigated and a comparison is made with an established technique. Methods and results: The method is derived from the Fick principle and uses indocyanine green dye, injected into the bypass circuit, as an intravascular tracer. Cerebral blood flow was measured in nine children undergoing cardiopulmonary bypass on a total of 49 occasions. Results from this study suggest that an integrating period of 4 seconds provided a consistent measurement of global cerebral blood flow. The values obtained ranged from 3.2 to 32.4 (median 15.9) ml · 100 gm-1 · min-1. In an additional 10 children in whom repeated measurements were made, the coefficient of variation was 11% ± 7% (mean ± standard deviation). In a further study, the method was compared with microsphere injection in five piglets undergoing cardiopulmonary bypass. The comparison within each animal with the linear least squares method gave values for R2 in the range 0.91 to 0.99. The gradients of the fits ranged from 0.5 to 1.8 (median 1.0). The mean difference between the two techniques was 5.7 ml · 100 gm-1 · min-1 or 7%. The coefficient of variation for the piglets was 14% ± 9% (mean ± standard deviation). Conclusions: Indocyanine green and near-infrared spectroscopy allow frequent and repeated measurements of cerebral blood flow during cardiopulmonary bypass. The measurements are reproducible and accurately reflect changes in cerebral blood flow. It may be widely applicable both in research and clinical practice.

0022-5223
94-102
Roberts, I.G.
4e298bf4-34e8-4a91-b202-88126db08344
Fallon, P.
448d79fe-cdb4-427f-aa50-492760899806
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Kirshbom, P.M.
baba6413-a4b3-4ee6-bcca-a4a3c7683318
Cooper, C.E.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Elliott, M. J.
9e50eb7b-090c-4065-9e3e-3cd1466573d4
Edwards, A.D.
7030489d-2a34-492b-9091-b9da1bb25d3d
Roberts, I.G.
4e298bf4-34e8-4a91-b202-88126db08344
Fallon, P.
448d79fe-cdb4-427f-aa50-492760899806
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Kirshbom, P.M.
baba6413-a4b3-4ee6-bcca-a4a3c7683318
Cooper, C.E.
e05f5612-b493-4273-9b71-9e0ce32bdad6
Elliott, M. J.
9e50eb7b-090c-4065-9e3e-3cd1466573d4
Edwards, A.D.
7030489d-2a34-492b-9091-b9da1bb25d3d

Roberts, I.G., Fallon, P., Kirkham, F.J., Kirshbom, P.M., Cooper, C.E., Elliott, M. J. and Edwards, A.D. (1998) Measurement of cerebral blood flow during cardiopulmonary bypass with near-infrared spectroscopy. Journal of Thoracic and Cardiovascular Surgery, 115 (1), 94-102. (doi:10.1016/S0022-5223(98)70447-7).

Record type: Article

Abstract

Objective: A novel noninvasive method for repeatedly measuring cerebral blood flow during cardiopulmonary bypass by near-infrared spectroscopy is described. The reproducibility of the method is investigated and a comparison is made with an established technique. Methods and results: The method is derived from the Fick principle and uses indocyanine green dye, injected into the bypass circuit, as an intravascular tracer. Cerebral blood flow was measured in nine children undergoing cardiopulmonary bypass on a total of 49 occasions. Results from this study suggest that an integrating period of 4 seconds provided a consistent measurement of global cerebral blood flow. The values obtained ranged from 3.2 to 32.4 (median 15.9) ml · 100 gm-1 · min-1. In an additional 10 children in whom repeated measurements were made, the coefficient of variation was 11% ± 7% (mean ± standard deviation). In a further study, the method was compared with microsphere injection in five piglets undergoing cardiopulmonary bypass. The comparison within each animal with the linear least squares method gave values for R2 in the range 0.91 to 0.99. The gradients of the fits ranged from 0.5 to 1.8 (median 1.0). The mean difference between the two techniques was 5.7 ml · 100 gm-1 · min-1 or 7%. The coefficient of variation for the piglets was 14% ± 9% (mean ± standard deviation). Conclusions: Indocyanine green and near-infrared spectroscopy allow frequent and repeated measurements of cerebral blood flow during cardiopulmonary bypass. The measurements are reproducible and accurately reflect changes in cerebral blood flow. It may be widely applicable both in research and clinical practice.

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Published date: January 1998

Identifiers

Local EPrints ID: 429809
URI: http://eprints.soton.ac.uk/id/eprint/429809
ISSN: 0022-5223
PURE UUID: 7869c792-2ad3-40af-a282-fe1fc4be72d9
ORCID for F.J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958
ORCID for C.E. Cooper: ORCID iD orcid.org/0000-0003-3510-0709

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Date deposited: 05 Apr 2019 16:30
Last modified: 13 Aug 2022 01:39

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Contributors

Author: I.G. Roberts
Author: P. Fallon
Author: F.J. Kirkham ORCID iD
Author: P.M. Kirshbom
Author: C.E. Cooper ORCID iD
Author: M. J. Elliott
Author: A.D. Edwards

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