Cerebral oxygenation is an indication of oxygen supply and demand in the brain. It has become a crucial approach to perioperative anesthesia management having shown benefit in both cardiac and general surgery procedures . The brain can be used as an “index organ” to monitor desaturation , and can act as an early warning system to indicate overall oxygen demand deficits, which could lead to further complications . Oxygen desaturation occurs in as many as 80% of procedures and can lead to post-operative decline, further health complications, higher medical costs and a decrease in patient well being.
​
Cerebral oximetry using near infrared spectroscopy (NIRS) is a non-invasive, continuous, and easy to use method that has been around for over a decade. Although cerebral oximetry is gaining attraction it is still not being used to its fullest potential. Through our investigations there are two main limitations, cost and specificity of the readings, due to weighted average of the superficial and deep saturations.
​
1,2
3
4
Our solution to improve cerebral oximetry monitoring
In order to increase the use by hospitals and clinics, we have developed the VO200 - NeurOs Cerebral Oximetry as a solution to overcome the current limitations of existing cerebral oximetry technologies. The NeurOs system uses a reusable sensor with disposable adhesive in order to reduce costs, and the sensor has integrated signal amplification, analogue digital conversion, data processing, embedded algorithms, with depth resolved oximetry (differentiates readings from the scalp and deep tissue) to provide improved signal to noise ratio and confidence in the values to clinicians. In addition the NeurOs system provides an additional parameter of blood volume index (BVI) as an indication of regional blood to tissue volume ratio. The price, accuracy, and additional parameter of BVI provided with our VO 200 – NeurOs Cerebral Oximetry is quite compelling compared to other commercially available cerebral oximeters.
Advantages of using our NeurOs Cerebral Oximetry
Advantages of using the VO 200 - NeurOs Cerebral Oxiemtry versus other commercially available cerebral oximeters
Accuracy - highest Absolute Trending Accuracy of ±1.5% of tissue oxygenation
hello
Additional Parameters - new Blood Volume Index (BVI) which correlates closely which indicates the regional blood to tissue volume ratio
hello
Low Cost - reusable sensors that offers exceptional value with superior signal quality at a fraction of the cost compared to the traditional one time use sensors
hello
Ease of use - straightforward and convenient operating system that can run on either tablet, laptop, computer, or any third-party monitors of your choice
hello
​
Other commercially available cerebral oximeters such as FORESIGHT™ (CAS Medical Systems, Brantford, CT, USA), INVOS™ 5100C (Covidien, Boulder, CO, USA), and EQUANOX™ 7600 (Nonin Medical, Plymouth, MN, USA) have been tested under similar hypoxia protocols .
5,6
Accuracy (Absolute) and Accuracy (Trending) for the FORESIGHT (Edwards LifeSciences, Irvine, CA, USA), INVOS® 5100C (Covidien, Boulder, CO, USA), EQUANOX™ 7600 (Nonin Medical, Plymouth, MN, USA)
5,6
References​
-
Murkin JM, Adams SJ, Novick RJ, Quantz M, Bainbridge D, Iglesias I, Cleland A, Schaefer B, Irwin B, Fox S. Monitoring brain oxygen saturation during coronary bypass surgery: a randomized, prospective study. Anesth Analg. 2007 Jan;104(1):51-8.
-
Casati A, Fanelli G, Pietropaoli P, Proietti R, Tufano R, Danelli G, Fierro G, De Cosmo G, Servillo G. Continuous monitoring of cerebral oxygen saturation in elderly patients undergoing major abdominal surgery minimizes brain exposure to potential hypoxia. Anesth Analg. 2005 Sep;101(3):740-7
-
Murkin JM. Cerebral oximetry: monitoring the brain as the index organ. Anesthesiology. 2011 Jan;114(1):12-3.
-
Murkin JM, Arango M. Near-infrared spectroscopy as an index of brain and tissue oxygenation. Br J Anaesth. 2009 Dec;103 Suppl 1:i3-13.
-
MacLeod DB, Ikeda K, Vacchiano C, Lobbestael A, Wahr JA, Shaw AD. Development and validation of a cerebral oximeter capable of absolute accuracy. J Cardiothorac Vasc Anesth. 2012;26:1007-14
-
Bickler PE, Feiner JR, Eilers H, Rollins M. Performance of 5 cerebral oximeters during hypoxia in healthy volunteers. Proceedings of the 2011 Annual Meeting of the American Society of Anesthesiologists; Abstract LBT07