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A preliminary study of near-infrared spectroscopy in the monitoring of tissue perfusion in the distal lower limb and its application in hemodynamic reconstruction
Received:January 30, 2023  Revised:February 11, 2023  Click here to download the full text
Citation of this paper:XI Shuai-shuai,WANG Chao,JIN Jie,QU Le-feng,BAI Jun.A preliminary study of near-infrared spectroscopy in the monitoring of tissue perfusion in the distal lower limb and its application in hemodynamic reconstruction[J].Chinese Journal of Clinical Medicine,2023,30(1):38-43
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Author NameAffiliationE-mail
XI Shuai-shuai Department of Vascular and Endovascular Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200070, China
School of Clinical Medicine, Weifang Medical University, Weifang 261053, Shandong, China 
 
WANG Chao Department of Vascular and Endovascular Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200070, China  
JIN Jie Department of Vascular and Endovascular Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200070, China  
QU Le-feng Department of Vascular and Endovascular Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200070, China  
BAI Jun Department of Vascular and Endovascular Surgery, The Second Affiliated Hospital of Naval Medical University, Shanghai 200070, China baijun@smmu.edu.cn 
Abstract:Objective To explore the application value of near-infrared spectroscopy (NIRS) monitoring in the monitoring of tissue perfusion in the distal lower extremity and in the revascularization. Methods From August 2021 to October 2022, 60 patients who were hospitalized in the Department of Vascular Surgery of the Second Affiliated Hospital of the Naval Military Medical University and were clinically diagnosed as arteriosclerosis obliterans of the lower extremity and underwent lower extremity revascularization were retrospectively selected. The patients were divided into NIRS group (n=30) and non-NIRS group (n=30) according to whether to use near-infrared spectroscopy monitoring during operation. NIRS group was further divided into T2DM subgroup (n=13) and non T2DM subgroup (n=17) according to whether the patient had diabetes. The general data of patients were collected. In NIRS group, rSO2 was monitored during perioperative period and the values of rSO2 and ABI were recorded before and after operation. Record the details of the patient's operation, adverse events, secondary surgical intervention and other data. Results There was no statistically significant difference in baseline data between NIRS group and non-NIRS group, with 5 (16.7%) and 3 (10.0%) adverse events respectively. After operation, rSO2 and ABI in NIRS group were significantly higher than those before operation (P<0.05), and there was a correlation between rSO2 and ABI in affected limbs before and after operation (r=0.701, P<0.001; r=0.548, P=0.002). After operation, rSO2 and ABI in T2DM subgroup and non-T2DM subgroup were significantly higher than those before operation (P<0.05). There was no statistically significant difference in rSO2 and ABI between the two groups before operation. After operation, rSO2 and ABI in non-T2DM group were significantly higher than those in T2DM group (P<0.05). There was no correlation between rSO2 and ABI before and after operation in T2DM subgroup (P=0.062, P=0.354), while there was correlation between rSO2 and ABI before and after operation in non-T2DM subgroup (r=0.767, P<0.001; r=0.688, P=0.002). Conclusions NIR monitoring can reflect the oxygenation and perfusion of lower limb tissue through the level and change of rSO2, which has certain guiding significance for the drug application during surgical diagnosis and treatment and follow-up. In the perioperative period of lower limb artery reconstruction, sudden adverse events can be found immediately, which can guide the adjustment of treatment measures, improve the prognosis and reduce the occurrence of related complications.
keywords:arteriosclerosis obliterans  near-infrared spectroscopy  tissue perfusion monitoring  diabetes  revascula-rization
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