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Master Thesis

Monitorage de l’oxygénation cérébrale du patient cérébrolésé : interchangeabilité de la NIRS & de la PtiO2

Abstract : Objective: continuous monitoring of cerebral oxygenation is part of the therapeutic tools for brain damaged patients. Direct and invasive measurement of cerebral oxygenation using a probe (PbtO2) is promising but invasive. A non-invasive evaluation of regional transcranial oxygen saturation using near-infrared spectroscopy (NIRS) may be possible. The aim of this study was to assess the interchangeability between PbtO2 and NIRS over time in brain damaged patients. Methods: this is a retrospective study conducted in the neuro-intensive care unit of Bordeaux University Hospital. Fifty-eight severely brain-injured patients were equipped with a PbtO2 probe and a homolaterally NIRS sensor for simultaneous hourly measurements of PbtO2 and NIRS values for 72 consecutive hours. Measurements and Main Results: a total of 3988 simultaneous measurements of NIRS and PbtO2 was obtained. Point-wise correlation ranged from -0.25 and 0.25. Global correlation over time was 0.013 (p= 0.457). The bivariate linear-mixed model confirmed no significant correlation between the Pbt02 and NIRS follow-up. The concordance rate between rSO2 and PbtO2 was 41.8%. NIRS was not able to detect PbtO2 values less than 20 mmHg (Area Under Receiver Operating curve = 0.537 ([0.534 - 0.539]; p= 0.664) and percentage changes in NIRS was not able to detect a decrease in PbtO2 10% (Area Under Receiver Operating curve = 0.615 [0.614 - 0.616], p < 0.001). Conclusion: PbtO2 and NIRS measurements were not correlated. There is no evidence that NIRS could constitute a substitute for monitoring of PbtO2 at bedside in neurocritical care unit patients.
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https://dumas.ccsd.cnrs.fr/dumas-03425466
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Submitted on : Wednesday, November 10, 2021 - 6:22:24 PM
Last modification on : Friday, December 17, 2021 - 3:47:06 AM

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  • HAL Id : dumas-03425466, version 1

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Estelle Tuaz. Monitorage de l’oxygénation cérébrale du patient cérébrolésé : interchangeabilité de la NIRS & de la PtiO2. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03425466⟩

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