Measurement of Cerebral Blood Flow in Dogs with Near Infrared Spectroscopy in the Reflectance Mode Is Invalid

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Abstract
Near infrared spectroscopy (NIRS) is used to measure CBF (CBFNIRS) in humans, based on Fick's principle, using oxygen as an intravascular tracer. We compared CBFNIRS with CBF measured by microspheres (CBFμ) and the venous outflow technique (CBFv) in 15 dogs, altering CBF with ventilation-induced changes in PaCO2. Five hundred forty-nine CBFNIRS measurements were attempted using an integration time of 2.5 s on the saturation signal from the tongue. One hundred ninety-eight (36.1%) of the measurements fulfilled predefined criteria. The coefficient of variation (CV) for six measurements under stable conditions was 29.1%. The CBFNIRS measurements correlated best with microsphere-measured blood flows in the cortical gray matter (median 0.43, range 0.16–0.93); the contributions of the skull and dura were variable. The CBFv varied by a median of 12% (range 0–67%) during the CBFNIRS measurements. The percentage of acceptable CBFNIRS measurements, the CV, and the correlation coefficients of the CBFNIRS were improved by using saturation signal directly from the artery and varying the integration time with an estimate of the minimum transit time. The current method of measuring CBFNIRS in the reflectance mode is inaccurate when compared with other accepted techniques.