Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort Study
Brain tissue oxygen tension (PbtO<sub>2</sub>) has emerged as a cerebral monitoring modality following traumatic brain injury (TBI). Near-infrared spectroscopy (NIRS)-based regional cerebral oxygen saturation (rSO<sub>2</sub>) can non-invasively examine cerebral oxygen conten...
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MDPI AG
2023-09-01
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| Online Access: | https://www.mdpi.com/2306-5354/10/10/1124 |
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| author | Alwyn Gomez Donald Griesdale Logan Froese Eleen Yang Eric P. Thelin Rahul Raj Marcel Aries Clare Gallagher Francis Bernard Andreas H. Kramer Frederick A. Zeiler |
| author_facet | Alwyn Gomez Donald Griesdale Logan Froese Eleen Yang Eric P. Thelin Rahul Raj Marcel Aries Clare Gallagher Francis Bernard Andreas H. Kramer Frederick A. Zeiler |
| author_sort | Alwyn Gomez |
| collection | DOAJ |
| description | Brain tissue oxygen tension (PbtO<sub>2</sub>) has emerged as a cerebral monitoring modality following traumatic brain injury (TBI). Near-infrared spectroscopy (NIRS)-based regional cerebral oxygen saturation (rSO<sub>2</sub>) can non-invasively examine cerebral oxygen content and has the potential for high spatial resolution. Past studies examining the relationship between PbtO<sub>2</sub> and NIRS-based parameters have had conflicting results with varying degrees of correlation. Understanding this relationship will help guide multimodal monitoring practices and impact patient care. The aim of this study is to examine the relationship between PbtO<sub>2</sub> and rSO<sub>2</sub> in a cohort of TBI patients by leveraging contemporary statistical methods. A multi-institutional retrospective cohort study of prospectively collected data was performed. Moderate-to-severe adult TBI patients were included with concurrent rSO<sub>2</sub> and PbtO<sub>2</sub> monitoring during their stay in the intensive care unit (ICU). The high-resolution data were analyzed utilizing time series techniques to examine signal stationarity as well as the cross-correlation relationship between the change in PbtO<sub>2</sub> and the change in rSO<sub>2</sub> signals. Finally, modeling of the change in PbtO<sub>2</sub> by the change in rSO<sub>2</sub> was attempted utilizing linear methods that account for the autocorrelative nature of the data signals. A total of 20 subjects were included in the study. Cross-correlative analysis found that changes in PbtO<sub>2</sub> were most significantly correlated with changes in rSO<sub>2</sub> one minute earlier. Through mixed-effects and time series modeling of parameters, changes in rSO<sub>2</sub> were found to often have a statistically significant linear relationship with changes in PbtO<sub>2</sub> that occurred a minute later. However, changes in rSO<sub>2</sub> were inadequate to predict changes in PbtO<sub>2</sub>. In this study, changes in PbtO<sub>2</sub> were found to correlate most with changes in rSO<sub>2</sub> approximately one minute earlier. While changes in rSO<sub>2</sub> were found to contain information about future changes in PbtO<sub>2</sub>, they were not found to adequately model them. This strengthens the body of literature indicating that NIRS-based rSO<sub>2</sub> is not an adequate substitute for PbtO<sub>2</sub> in the management of TBI. |
| first_indexed | 2024-03-10T21:26:29Z |
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| last_indexed | 2024-03-10T21:26:29Z |
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| spelling | doaj.art-744b656a05c34104b6bd9b7f2fdc877e2023-11-19T15:41:18ZengMDPI AGBioengineering2306-53542023-09-011010112410.3390/bioengineering10101124Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort StudyAlwyn Gomez0Donald Griesdale1Logan Froese2Eleen Yang3Eric P. Thelin4Rahul Raj5Marcel Aries6Clare Gallagher7Francis Bernard8Andreas H. Kramer9Frederick A. Zeiler10Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, CanadaDepartment of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, CanadaBiomedical Engineering, Faculty of Engineering, University of Manitoba, Winnipeg, MB R3T 2N2, CanadaDepartment of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC V6T 1Z4, CanadaDepartment of Neurology, Karolinska University Hospital, 171 76 Stockholm, SwedenDepartment of Neurosurgery, University of Helsinki and Helsinki University Hospital, FI-00029 Helsinki, FinlandDepartment of Intensive Care, Maastricht University Medical Center, 6229 Maastricht, The NetherlandsSection of Neurosurgery, Department of Clinical Neurosciences, University of Calgary, Calgary, AB T2N 1N4, CanadaSection of Critical Care, Department of Medicine, University of Montreal, Montreal, QC H3T 1J4, CanadaDepartment of Clinical Neurosciences, University of Calgary, Calgary, AB T2N 1N4, CanadaDepartment of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, CanadaBrain tissue oxygen tension (PbtO<sub>2</sub>) has emerged as a cerebral monitoring modality following traumatic brain injury (TBI). Near-infrared spectroscopy (NIRS)-based regional cerebral oxygen saturation (rSO<sub>2</sub>) can non-invasively examine cerebral oxygen content and has the potential for high spatial resolution. Past studies examining the relationship between PbtO<sub>2</sub> and NIRS-based parameters have had conflicting results with varying degrees of correlation. Understanding this relationship will help guide multimodal monitoring practices and impact patient care. The aim of this study is to examine the relationship between PbtO<sub>2</sub> and rSO<sub>2</sub> in a cohort of TBI patients by leveraging contemporary statistical methods. A multi-institutional retrospective cohort study of prospectively collected data was performed. Moderate-to-severe adult TBI patients were included with concurrent rSO<sub>2</sub> and PbtO<sub>2</sub> monitoring during their stay in the intensive care unit (ICU). The high-resolution data were analyzed utilizing time series techniques to examine signal stationarity as well as the cross-correlation relationship between the change in PbtO<sub>2</sub> and the change in rSO<sub>2</sub> signals. Finally, modeling of the change in PbtO<sub>2</sub> by the change in rSO<sub>2</sub> was attempted utilizing linear methods that account for the autocorrelative nature of the data signals. A total of 20 subjects were included in the study. Cross-correlative analysis found that changes in PbtO<sub>2</sub> were most significantly correlated with changes in rSO<sub>2</sub> one minute earlier. Through mixed-effects and time series modeling of parameters, changes in rSO<sub>2</sub> were found to often have a statistically significant linear relationship with changes in PbtO<sub>2</sub> that occurred a minute later. However, changes in rSO<sub>2</sub> were inadequate to predict changes in PbtO<sub>2</sub>. In this study, changes in PbtO<sub>2</sub> were found to correlate most with changes in rSO<sub>2</sub> approximately one minute earlier. While changes in rSO<sub>2</sub> were found to contain information about future changes in PbtO<sub>2</sub>, they were not found to adequately model them. This strengthens the body of literature indicating that NIRS-based rSO<sub>2</sub> is not an adequate substitute for PbtO<sub>2</sub> in the management of TBI.https://www.mdpi.com/2306-5354/10/10/1124traumatic brain injurybrain tissue oxygen tensionregional cerebral oxygen saturationnear-infrared spectroscopymultimodal monitoring |
| spellingShingle | Alwyn Gomez Donald Griesdale Logan Froese Eleen Yang Eric P. Thelin Rahul Raj Marcel Aries Clare Gallagher Francis Bernard Andreas H. Kramer Frederick A. Zeiler Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort Study Bioengineering traumatic brain injury brain tissue oxygen tension regional cerebral oxygen saturation near-infrared spectroscopy multimodal monitoring |
| title | Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort Study |
| title_full | Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort Study |
| title_fullStr | Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort Study |
| title_full_unstemmed | Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort Study |
| title_short | Temporal Statistical Relationship between Regional Cerebral Oxygen Saturation (rSO<sub>2</sub>) and Brain Tissue Oxygen Tension (PbtO<sub>2</sub>) in Moderate-to-Severe Traumatic Brain Injury: A Canadian High Resolution-TBI (CAHR-TBI) Cohort Study |
| title_sort | temporal statistical relationship between regional cerebral oxygen saturation rso sub 2 sub and brain tissue oxygen tension pbto sub 2 sub in moderate to severe traumatic brain injury a canadian high resolution tbi cahr tbi cohort study |
| topic | traumatic brain injury brain tissue oxygen tension regional cerebral oxygen saturation near-infrared spectroscopy multimodal monitoring |
| url | https://www.mdpi.com/2306-5354/10/10/1124 |
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