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Review
. 2021 Mar;70(3):190-203.
doi: 10.1007/s00101-020-00837-z.

[Near-infrared spectroscopy : Technique, development, current use and perspectives]

[Article in German]
D Bolkenius  1 , C Dumps  2 , B Rupprecht  2
Affiliations
Review

[Near-infrared spectroscopy : Technique, development, current use and perspectives]

[Article in German]
D Bolkenius et al. Anaesthesist. 2021 Mar.

Abstract
in English, German

Near-infrared spectroscopy (NIRS) has been available in research and clinical practice for more than four decades. Recently, there have been numerous publications and substantial developments in the field. This article describes the clinical application of NIRS in relation to current guidelines, with a focus on pediatric and cardiac anesthesia. It discusses technical and physiological principles, pitfalls in clinical use and presents (patho)physiological influencing factors and derived variables, such as fractional oxygen extraction (FOE) and the cerebral oxygen index (COx). Recommendations for the interpretation of NIRS values in connection with influencing factors, such as oxygen transport capacity, gas exchange and circulation as well as an algorithm for cardiac anesthesia are presented. Limitations of the method and the lack of comparability of values from different devices as well as generally accepted standard values are explained. Technical differences and advantages compared to pulse oxymetry and transcranial Doppler sonography are illuminated. Finally, the prognostic significance and requirements for future clinical studies are discussed.

Seit über 4 Jahrzehnten ist die Nahinfrarotspektroskopie (NIRS) in Forschung und klinischer Praxis verfügbar. Zuletzt gab es zahlreiche Veröffentlichungen und wesentliche Entwicklungen auf diesem Gebiet. Dieser Beitrag beschreibt die klinische Anwendung von NIRS in Bezug auf aktuelle Leitlinien, mit dem Schwerpunkt auf der Kinder- und Herzanästhesie. Es werden technische und physiologische Grundlagen und Fallstricke im klinischen Einsatz diskutiert sowie (patho-)physiologische Einflussfaktoren und abgeleitete Größen wie die „fractional oxygen extraction“ (FOE) und der „cerebral oxygen index“ (COx) dargestellt. Empfehlungen für die Interpretation von NIRS-Werten im Zusammenhang mit Einflussfaktoren wie Sauerstofftransportkapazität, Gasaustausch und Kreislauf sowie ein Algorithmus für die Kardioanästhesie werden präsentiert. Limitationen der Methode und die fehlende Vergleichbarkeit von Werten verschiedener Geräte sowie allgemein anerkannte Normwerte werden erklärt. Technische Unterschiede und Vorteile gegenüber Pulsoxymetrie und transkranieller Dopplersonographie werden beleuchtet. Abschließend werden die prognostische Bedeutung und Anforderungen an zukünftige klinische Studien erörtert.

Keywords: Cardiac surgical procedures; Cerebral perfusion; Infant; Oxygenation; Vascular surgery.

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Comment in

  • [NIRS-Are we really measuring what we want to measure?].
    Kerz T. Kerz T. Anaesthesist. 2021 May;70(5):434-435. doi: 10.1007/s00101-021-00957-0. Epub 2021 Apr 6. Anaesthesist. 2021. PMID: 33824997 German. No abstract available.
  • [Limitations of a method].
    Bolkenius D, Dumps C, Rupprecht B. Bolkenius D, et al. Anaesthesist. 2021 May;70(5):436-438. doi: 10.1007/s00101-021-00958-z. Epub 2021 Apr 21. Anaesthesist. 2021. PMID: 33884440 German. No abstract available.

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