Effect of assuming constant tissue scattering on measured tissue oxygenation values during tissue ischemia and vascular reperfusion

Abstract

The purpose of this study was to determine the effects of assuming constant tissue scattering properties on tissue oxygenation measurements during a vascular occlusion test (VOT). Twenty-one subjects (21.8 ± 1.9 yr) completed a VOT [1 min baseline (BL), 5 min of tissue ischemia (TI), and 3 min of vascular reperfusion (VR)]. Absolute concentrations of oxygenated heme (oxy-[heme]), deoxygenated heme (deoxy-[heme]), total heme (total [heme), tissue oxygen saturation (StO2), and heme difference [heme]diff) were measured using frequency domain near-infrared spectroscopy (FD-NIRS) while 1) continuously measuring and incorporating tissue scattering ([Formula: see text]) and 2) assuming scattering remained constant. FD-NIRS measured [Formula: see text] increased during TI at 692 nm ( P < 0.001) and decreased at 834 nm ( P < 0.001). During VR, [Formula: see text] decreased at 692 nm ( P < 0.001) and increased at 834 nm ( P < 0.001). When assuming constant scattering, oxy-[heme] was significantly less at TIpeak ( P < 0.05) while deoxy-[heme] and StO2 were significantly altered at BL, TIpeak, and VRpeak (all P < 0.001). Total [heme] did not change during the VOT. Absolute changes in deoxy-[heme], oxy-[heme], and StO2 in response to TI and VR were significantly exaggerated (all P < 0.001) and the rates of change during TI ( slope 1) and VR ( slope 2) in deoxy-[heme], oxy-[heme], StO2, and [heme]diff were significantly increased (all P < 0.05) when constant tissue scattering was assumed. These findings demonstrate the need for caution when interpreting NIRS data without continuously measuring tissue optical properties. Further, assuming tissue optical properties remain constant may have important consequences to experimental data and clinical conclusions made using NIRS. NEW & NOTEWORTHY NIRS measurements provide significant experimental and clinical insight. We demonstrate that absolute changes in tissue oxygenation measurements made with NIRS are overestimated and the kinetic responses of NIRS measurements are exaggerated by varying degrees among individuals if tissue scattering characteristics are assumed to remain constant during vascular occlusion tests.