Abstract
The aim of the present study was to evaluate the performance of regional oxygen saturation (rSO2) monitoring with near infrared spectroscopy (NIRS) during pediatric inter-hospital transports and to optimize processing of the electronically stored data. Cerebral (rSO2-C) and abdominal (rSO2-A) NIRS sensors were used during transport in air ambulance and connecting ground ambulance. Data were electronically stored by the monitor during transport, extracted and analyzed off-line after the transport. After removal of all zero and floor effect values, the Savitzky–Golay algorithm of data smoothing was applied on the NIRS-signal. The second order of smoothing polynomial was used and the optimal number of neighboring points for the smoothing procedure was evaluated. NIRS-data from 38 pediatric patients was examined. Reliability, defined as measurements without values of 0 or 15%, was acceptable during transport (> 90% of all measurements). There were, however, individual patients with < 90% reliable measurements during transport, while no patient was found to have < 90% reliable measurements in hospital. Satisfactory noise reduction of the signal, without distortion of the underlying information, was achieved when 20–50 neighbors (“window-size”) were used. The use of NIRS for measuring rSO2 in clinical studies during pediatric transport in ground and air-ambulance is feasible but hampered by unreliable values and signal interference. By applying the Savitzky–Golay algorithm, the signal-to-noise ratio was improved and enabled better post-hoc signal evaluation.
Highlights
Near-infrared light passes through tissues such as skin and bone with minimal absorption, the two main absorbers of near-infrared light in blood being oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) [1]
There are few studies of Near-infrared spectroscopy (NIRS) utilization in a transport environment and only two concerning pediatric patients [8, 9]. These studies suggest that cerebral oxygenation monitoring with NIRS can be used in a transport environment and that NIRS might be a useful complement to existing monitoring during inter-hospital transports [8,9,10,11]
The aim of the present study was to evaluate the performance of rSO2 monitoring with NIRS during pediatric inter-hospital transport and to optimize processing of the electronically stored data
Summary
Near-infrared light passes through tissues such as skin and bone with minimal absorption, the two main absorbers of near-infrared light in blood being oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) [1]. The difference in absorption of HbO2 and HbR is measured and represents the regional oxygen saturation (rSO2) of the tissue. Pediatric studies have demonstrated good correlation between cerebral rSO2 and jugular venous bulb saturation [4]. There are few studies of NIRS utilization in a transport environment and only two concerning pediatric patients [8, 9] These studies suggest that cerebral oxygenation monitoring with NIRS can be used in a transport environment and that NIRS might be a useful complement to existing monitoring during inter-hospital transports [8,9,10,11]. In the two studies concerning pediatric patients the same type of monitor was used (INVOS 5100C), but a number of monitors have been used in different studies
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