Measurements of Tissue Oxygen and Hemoglobin on a Near Infra-red Spectroscopy
in Emergency Patients with Poor General Conditions
Takeji Saitoh, MD, PhD1, Naohiro Kanayama, MD, PhD2, Masatsugu Niwayama, PhD3, Hiroshi Satoh, MD, PhD4, Yoshiaki Takahashi, MD1, Hironao Hozumi, MD, PhD1, Toshiyuki Uchida, MD, PhD2, Masao Saotome, MD, PhD4, Tsuyoshi Urushida, MD, PhD4, Hideki Katoh, MD, PhD4, Hideharu
Hayashi, MD, PhD4, and Atsuto Yoshino, MD, PhD1
1Department of Emergency and Disaster Medicine, Hamamatsu University School of Medicine, 2Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, 3Department of Electrical and Electronic Engineering, Shizuoka University Graduate School of Engineering, 4Divisionof Cardiology, Internal Medicine III, Hamamatsu University School of Medicine
Index finger pulp (IF)Introduction
Introduction

Results 3. rSO2

Sternocleidomastoid muscle (SM)rSO2 in ER patients

rSO2 in normal control
・In patients with poor general conditions, conventional pulse oximeters are sometimes unable
to determine the oxygen saturation because of peripheral arteriole constriction.
・We developed a miniaturized sensor of near infra-red spectroscopy (NIRS) whose sourcedetector distance is shorter to detect regional oxygen saturation when examiners mount it on
their fingers. 1)
・This system was applied to the trasnvaginal evaluation of fetal oxygen dynamics during 2ndstage of labor. 2)

Thenar eminence (TE)

Results

Reference
1) N. Kanayama and M Niwayama. Journal of Biomedical Optics 19(6):067008
2) T. Uchida et al. J. Perinat. Med. 2015 [in press]

Results 1. Patients characteristics
Methods

Age (y.o.)Male/Female
Systolic BP (mmHg)
Diastolic BP (mmHg)Pulse (bpm)・We collected 22 normal control (male/female: 11/11, age: 45±15 y.o.) and 83 patients taken toour ER in an ambulance due to various diseases or injuries including cardio-pulmonary arrest asa pilot study.
・It was investigated whether measurement of arterial oxygen saturation by a conventional pulse
oximeter was available.
・We measured total hemoglobin index (T-HbI) and regional tissue oxygenation (rSO2) on index
finger pulp (IF), thenar eminence (TM) and sternocleidomastoid muscle (SM) using NIRS withthe miniaturized sensor, “Toccare (Astem Co., Ltd., Kawasaki, Japan) ”.
・T-HbI and rSO2 were compared among each part, and between normal control and patients.

Baseline diseases

66±2048/35
130±4874±28
78±28

Cardiovascular disease
CNS disease
Gastrointestinal disease
InjuryInfection
PoisoningRespiratory disease
Endocrine disease
Renal disease

17161212
10
6
4
32(%)
8080(%)

60
60

60
60

40
40

40
40

20
20

20
20

00

P<0.001
P<0.001

80
80

IF60 (58-61)

TE58 (56-60)

SM58 (56-59)*IF53 (49-56)

TE57 (55-60)

SM58 (53-62)

The value of rSO2 on index finger pulp in ER patients was significantly lower than that on thenar eminenceand sternocleidomastoid muscle, besides being significantly lower than that in normal control (*p<0.001).

Results 4. T-HbI and rSO2 in patients unavailable ofconventional pulse oximeter

Results 2. T-HbI
T-HbI in normal control
(mM)
880
0

P<0.01

T-HbI in ER patients(mM)
P<0.00180
80

P<0.001

P<0.001

6600

6060

440
04040

Black dots: patients with cardio-pulmonary arrest
Red dots: patients unavailable of conventional
pulse oximeter

IF22002200

IF
18 (17-21)

TE31 (29-34)

SM24 (18-29)

IF
13 (11-15)

SM

T-HII and rO2 were obtained stably even in 5 patients who needed CPR and 5 patients who showedno data by conventional pulse oximeter.

00Fig 1. NIRS with a new miniaturized tissue oxygenation sensor
The bare chips of the LEDs and photodiodes were mounted on the substrate with a wirebonding. The detectors were located 6 and 8 mm away from the LEDs in order to determine
an absolute value of the hemoglobin concentration using the spatially resolved NIRS. Thissystem can work by batteries.

*SMTEIFTE
The background graphs are same as the result 2 and 3 in ER patients.

TE
25 (22-29)

SM
23 (18-29)

In normal control, the value of T-HbI on thenar eminence is the highest. In ER patients, the value on
index finger pulp is the lowest, besides being significantly lower than that in normal control.

Conclusions
NIRS with the new miniaturized tissue oxygenation sensor is available to measure T-HbI and rSO2 onvarious places in human body, regardless of whether pulse waves are detected or not. In scenes such as ER
or disaster, we could use it for evaluating all patients’ condition immediately.

COI: We have no relevant relationship of financial/material support to disclose. The AHA-ReSS 2015, Nov 9th, 2015.