Benchmarking of Four Near Infrared Spectroscopy Devices for Long Time Use in Neonates

Abstract

Background Using near-infrared spectroscopy (NIRS) mixed tissue saturation can be calculated by measuring the oxygen saturation of oxygenated and deoxygenated erythrocytes in the tissue. Quality of the calculated value is not only dependent on the exposure of the measured values in the calculation, but also on external factors such as artifacts. Main object of this study was to determine whether and how the measurement quality of different devices varies in their long-term use in premature infants.

Patients and Methods In 54 measurements, each lasting 2 hours, 4 NIRS devices were attached in pairs on the forehead of 9 cardio-respiratory stable, spontaneous breathing premature infants. Pooled meta-analysis was used to compare the correlation between regional tissue saturation to the pulse oximetry saturation per device.

Results The pooled random effect of all Pearson’s correlation coefficients was 0.490 (CI95: 0.403-0.568) with the NIRO 200, 0.575 (CI95: 0.463-0.668) with the INVOS 5100c, 0.712 (CI95: 0.640-0.772) with the Fore-Sight and 0.638 (CI95: 0.554-0.709) with the SenSmart X- 100.

Conclusion In this trial, a significant correlation between the tissue saturation and pulsoxymetry saturation was observed. The tremendous variation range among the measurements showed, however, that the measurement quality can be severely affected by unrecognized artifacts, after excluding other possible causes. None of the devices had reliable artifact detection for long-term measurements in very small premature infants. Key words: Near-Infrared-Spectroscopy, premature infants, Benchmark Test, Long-term measurements

Zusammenfassung

Hintergrund Mittels Nah-Infrarot-Spektroskopie (NIRS) wird durch Messung der Sauerstoffsättigung von oxygenierten und deoxygenierten Erythrozyten im Gewebe eine gemischte Gewebesättigung berechnet. Die Qualität dieses Rechenwerts ist nicht nur von der Gewichtung der Messwerte in der Berechnung, sondern auch von äußeren Einflüssen, wie Artefakten abhängig. Die vorliegende Studie soll untersuchen, ob und wie sich die Messqualität unterschiedlicher Geräte in der Langzeitanwendung bei Frühgeborenen unterscheidet.

Patienten und Methoden In 54 jeweils 2 Stunden dauernden Messungen wurden vier NIRS Geräte jeweils paarweise an der Stirn von 9 kardiorespiratorisch stabilen, spontan atmenden Frühgeborenen angebracht. Mittels gepoolten Metaanalysen wurde verglichen, wie sehr die Gewebesättigung der Einzelgeräte mit der pulsoxymetrischen Sauerstoffsättigung korreliert.

Ergebnis Der gepoolte random Effekt des Pearson-Korrelationskoeffizienten über alle Messungen betrug 0,490 (KI95: 0,403–0,568) bei NIRO 200, 0,575 (KI95: 0,463–0,668) bei INVOS 5100c, 0,712 (KI95: 0,640–0,772) bei Fore-Sight und 0,638 (KI95: 0,554–0,709) bei SenSmart X-100.

Schlussfolgerung Grundsätzlich herrscht eine signifikante Korrelation zwischen Gewebesättigung und pulsoxymetrischer Sättigung. Die enorme Schwankungsbreite zwischen den Messungen zeigt jedoch, dass die Messqualität, nach Ausschluss anderer potentiellen Ursachen, stark von nicht erkannten Artefakten beeinträchtigt werden kann. Keines der Geräte verfügt über eine zuverlässige Artefakterkennung für Langzeitmessungen bei kleinen Frühgeborenen.

Key words

Near-infrared spectroscopy - premature infants - benchmark test - long-term monitoring

Schlüsselwörter

Nah-Infrarot Spektroskopie - Frühgeborene - Vergleich - Langzeitmessung

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