Near-Infrared Spectroscopy (NIRS) of Muscle HbO2 and MbO2 Desaturation During Exercise.

Abstract

Continuous noninvasive monitoring of muscle oxygenation has important clinical applications for muscle disorders such as compartmentation syndrome, fibromyalgia, deep vein thrombosis, malignant hyperthermia, and the assessment of training in athletic performance. NIRS has precisely such potential and has been used to detect deep venous thrombosis, evaluate athletic performance, and assess limb reperfusion and revascularization. The aim of this study was to examine the relationship between muscle hemoglobin oxygen (HbO2) and myoglobin (MbO2) desaturation using NIRS combined with venous blood sampling and HbO2 desaturation during forearm muscle exercise. Eleven normal subjects were studied, with informed consent and an IRB-approved protocol. A NIRS sensor (INVOS4100, Somanetics, Corp.) was applied on the volar aspect of the forearm. The subjects exercised their forearm by clenching and relaxing their fist while observing the oximeter and driving the reading to specified levels from 90% to 15% (minimum possible reading). Venous blood samples were withdrawn for measurement of blood gases and oxygen saturation (IL-Co-Oximeter). RSO2 (%) vs VO2 Sat showed a two-component HbO2 desaturation suggesting representation of venous HbO2 desaturation and perhaps myoglobin oxygen (MBO2) desaturation. Subtraction of the linear venous HbO2 curve from the two-component curve suggests MbO2 desaturation at venous hemoglobin oxygen saturation of about 10-20%. Conclusions: The kinetics of desaturation during exercise revealed two components representing HbO2 and MbO2 deoxygenation. The data show that MbO2 represents approximately 40% of the NIRS signal and the balance or 60% to HbO2.