Near-Infrared Spectroscopy Usefulness in Validation of Hyperventilation Test.
NIRS
cerebral blood flow
hyperventilation
hypocapnia
Journal
Medicina (Kaunas, Lithuania)
ISSN: 1648-9144
Titre abrégé: Medicina (Kaunas)
Pays: Switzerland
ID NLM: 9425208
Informations de publication
Date de publication:
06 Oct 2022
06 Oct 2022
Historique:
received:
31
07
2022
revised:
23
09
2022
accepted:
28
09
2022
entrez:
27
10
2022
pubmed:
28
10
2022
medline:
29
10
2022
Statut:
epublish
Résumé
Background: The hyperventilation test is used in clinical practice for diagnosis and therapeutic purposes; however, in the absence of a standardized protocol, the procedure varies significantly, predisposing tested subjects to risks such as cerebral hypoxia and ischemia. Near-infrared spectroscopy (NIRS), a noninvasive technique performed for cerebral oximetry monitoring, was used in the present study to identify the minimum decrease in the end-tidal CO2 (ETCO2) during hyperventilation necessary to induce changes on NIRS. Materials and Methods: We recruited 46 volunteers with no preexisting medical conditions. Each subject was asked to breathe at a baseline rate (8−14 breaths/min) for 2 min and then to hyperventilate at a double respiratory rate for the next 4 min. The parameters recorded during the procedure were the regional cerebral oxyhemoglobin and deoxyhemoglobin concentrations via NIRS, ETCO2, and the respiratory rate. Results: During hyperventilation, ETCO2 values dropped (31.4 ± 12.2%) vs. baseline in all subjects. Changes in cerebral oximetry were observed only in those subjects (n = 30) who registered a decrease (%) in ETCO2 of 37.58 ± 10.34%, but not in the subjects (n = 16) for which the decrease in ETCO2 was 20.31 ± 5.6%. According to AUC-ROC analysis, a cutoff value of ETCO2 decrease >26% was found to predict changes in oximetry (AUC-ROC = 0.93, p < 0.0001). Seven subjects reported symptoms, such as dizziness, vertigo, and numbness, throughout the procedure. Conclusions: The rise in the respiratory rate alone cannot effectively predict the occurrence of a cerebral vasoconstrictor response induced by hyperventilation, and synchronous ETCO2 and cerebral oximetry monitoring could be used to validate this clinical test. NIRS seems to be a useful tool in predicting vasoconstriction following hyperventilation.
Identifiants
pubmed: 36295560
pii: medicina58101396
doi: 10.3390/medicina58101396
pmc: PMC9607377
pii:
doi:
Substances chimiques
Oxyhemoglobins
0
Carbon Dioxide
142M471B3J
Vasoconstrictor Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Références
Acad Emerg Med. 2002 Apr;9(4):275-80
pubmed: 11927449
AJNR Am J Neuroradiol. 1997 Oct;18(9):1763-70
pubmed: 9367329
Neuroimage. 2013 Feb 1;66:71-9
pubmed: 23099101
Epilepsia. 2005 Jan;46(1):69-75
pubmed: 15660770
Am Heart J. 1945 Dec;30:557-66
pubmed: 21008276
Eur Respir J. 1991 Apr;4(4):393-9
pubmed: 1855568
Ann Emerg Med. 1994 Mar;23(3):560-3
pubmed: 8135434
Neuroimage. 2016 Dec;143:91-105
pubmed: 27591921
J Cardiothorac Vasc Anesth. 1996 Apr;10(3):406-18
pubmed: 8725427
Braz J Med Biol Res. 2000 Nov;33(11):1317-23
pubmed: 11050662
Anaesth Resusc Intensive Ther. 1975 Apr-Jun;3(2):135-40
pubmed: 241264
Am J Cardiol. 1982 Mar;49(4):834-41
pubmed: 7064832
Stroke. 1995 Dec;26(12):2285-92
pubmed: 7491652
Anesthesiology. 1998 May;88(5):1365-86
pubmed: 9605698
Anesth Analg. 2009 Sep;109(3):906-13
pubmed: 19690266
J Clin Monit Comput. 2012 Aug;26(4):279-87
pubmed: 22467064
Biomed Opt Express. 2019 Mar 28;10(4):2117-2134
pubmed: 31061774
Br Med J (Clin Res Ed). 1983 Apr 30;286(6375):1408-10
pubmed: 6404482
Adv Exp Med Biol. 1994;361:475-82
pubmed: 7597972
Anesthesiology. 2013 Jan;118(1):192-201
pubmed: 23221867
J Neurosurg Anesthesiol. 2020 Oct;32(4):288-299
pubmed: 31306264
Front Neurol. 2017 Jul 17;8:250
pubmed: 28769857
Int J Vasc Med. 2013;2013:629378
pubmed: 24455270
Brain Res. 2019 Jan 15;1703:41-52
pubmed: 29288644
J Cereb Blood Flow Metab. 2020 Jan;40(1):135-149
pubmed: 30353763
Complement Ther Med. 2021 Jan;56:102617
pubmed: 33189860
Am J Cardiol. 1997 Sep 1;80(5):545-9
pubmed: 9294979
Physiol Rep. 2015 Apr;3(4):
pubmed: 25907789
Front Neurosci. 2020 Jul 09;14:724
pubmed: 32742257
PLoS One. 2017 Jun 29;12(6):e0180187
pubmed: 28662195
Eur J Appl Physiol. 2018 Aug;118(8):1527-1538
pubmed: 29767351
Neurophotonics. 2022 Jul;9(3):030801
pubmed: 35832785
Am Ind Hyg Assoc J. 1983 Sep;44(9):685-9
pubmed: 6356858
Neurocrit Care. 2017 Dec;27(3):362-369
pubmed: 28664392