Continuous, noninvasive, and localized microvascular tissue oximetry using visible light spectroscopy

David A. Benaron, Ilian H. Parachikov, Shai Friedland, Roy Soetikno, John Brock-Utne, Peter J.A. Van Der Starre, Camran Nezhat, Martha K. Terris, Peter G. Maxim, Jeffrey J.L. Carson, Mahmood K. Razavi, Hayes B. Gladstone, Edgar F. Fincher, Christopher P. Hsu, F. Landon Clark, Wai Fung Cheong, Joshua L. Duckworth, David K. Stevenson

Research output: Contribution to journalArticle

71 Scopus citations

Abstract

Background: The authors evaluated the ability of visible light spectroscopy (VLS) oximetry to detect hypoxemia and ischemia in human and animal subjects. Unlike near-infrared spectroscopy or pulse oximetry (Spo 2), VLS tissue oximetry uses shallow-penetrating visible light to measure microvascular hemoglobin oxygen saturation (Sto2) in small, thin tissue volumes. Methods: In pigs, Sto2 was measured in muscle and enteric mucosa during normoxia, hypoxemia (Spo2 = 40-96%), and ischemia (occlusion, arrest). In patients, Sto2 Was measured in skin, muscle, and oral/enteric mucosa during normoxia, hypoxemia (Spo2 = 60-99%), and ischemia (occlusion, compression, ventricular fibrillation). Results: In pigs, normoxic Sto2 was 71 ± 4% (mean ± SD), without differences between sites, and decreased during hypoxemia (muscle, 11 ± 6%; P < 0.001) and ischemia (colon, 31 ± 11%; P < 0.001). In patients, mean normoxic Sto2 ranged from 68 to 77% at different sites (733 measures, 111 subjects); for each noninvasive site except skin, variance between subjects was low (e.g., colon, 69% ± 4%, 40 subjects; buccal, 77% ± 3%, 21 subjects). During hypoxemia, Sto 2 correlated with Spo2 (animals, r2 = 0.98; humans, r2 = 0.87). During ischemia, Sto2 initially decreased at -1.3 ± 0.2%/s and decreased to zero in 3-9 (r2 = 0.94). Ischemia was distinguished from normoxia and hypoxemia by a widened pulse/VLS saturation difference (Δ < 30% during normoxia or hypoxemia vs. Δ > 35% during ischemia). Conclusions: VLS oximetry provides a continuous, noninvasive, and localized measurement of the Sto2, sensitive to hypoxemia, regional, and global ischemia. The reproducible and narrow Sto2 normal range for oral/enteric mucosa supports use of this site as an accessible and reliable reference point for the VLS monitoring of systemic flow.

Original languageEnglish (US)
Pages (from-to)1469-1475
Number of pages7
JournalAnesthesiology
Volume100
Issue number6
DOIs
StatePublished - Jun 2004
Externally publishedYes

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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    Benaron, D. A., Parachikov, I. H., Friedland, S., Soetikno, R., Brock-Utne, J., Van Der Starre, P. J. A., Nezhat, C., Terris, M. K., Maxim, P. G., Carson, J. J. L., Razavi, M. K., Gladstone, H. B., Fincher, E. F., Hsu, C. P., Clark, F. L., Cheong, W. F., Duckworth, J. L., & Stevenson, D. K. (2004). Continuous, noninvasive, and localized microvascular tissue oximetry using visible light spectroscopy. Anesthesiology, 100(6), 1469-1475. https://doi.org/10.1097/00000542-200406000-00019