Changes in cerebral oxygenation and cerebral blood flow during hemodialysis - A simultaneous near-infrared spectroscopy and positron emission tomography study

Harmke A Polinder-Bos*, Jan Willem J Elting, Marcel Jh Aries, David Vállez García, Antoon Tm Willemsen, Peter J van Laar, Johanna Kuipers, Wim P Krijnen, Riemer HJA Slart, Gert Luurtsema, Ralf Westerhuis, Ron T Gansevoort, Carlo Ajm Gaillard, Casper Fm Franssen

*Corresponding author for this work

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Abstract

Near-infrared spectroscopy (NIRS) is used to monitor cerebral tissue oxygenation (rSO2) depending on cerebral blood flow (CBF), cerebral blood volume and blood oxygen content. We explored whether NIRS might be a more easy applicable proxy to [15O]H2O positron emission tomography (PET) for detecting CBF changes during hemodialysis. Furthermore, we compared potential determinants of rSO2 and CBF. In 12 patients aged ≥ 65 years, NIRS and PET were performed simultaneously: before (T1), early after start (T2), and at the end of hemodialysis (T3). Between T1 and T3, the relative change in frontal rSO2 (ΔrSO2) was -8 ± 9% ( P = 0.001) and -5 ± 11% ( P = 0.08), whereas the relative change in frontal gray matter CBF (ΔCBF) was -11 ± 18% ( P = 0.009) and -12 ± 16% ( P = 0.007) for the left and right hemisphere, respectively. ΔrSO2 and ΔCBF were weakly correlated for the left (ρ 0.31, P = 0.4), and moderately correlated for the right (ρ 0.69, P = 0.03) hemisphere. The Bland-Altman plot suggested underestimation of ΔCBF by NIRS. Divergent associations of pH, pCO2 and arterial oxygen content with rSO2 were found compared to corresponding associations with CBF. In conclusion, NIRS could be a proxy to PET to detect intradialytic CBF changes, although NIRS and PET capture different physiological parameters of the brain.

Original languageEnglish
Pages (from-to)328-340
Number of pages13
JournalJournal of Cerebral Blood Flow and Metabolism
Volume40
Issue number2
Early online date12-Dec-2018
DOIs
Publication statusPublished - Feb-2020

Keywords

  • Brain perfusion
  • cerebral oximetry
  • hemodialysis
  • NIRS
  • water-PET
  • CHRONIC-RENAL-FAILURE
  • DIALYSIS INITIATION
  • SIMULTANEOUS PET
  • BRAIN
  • ANGIOPOIETIN-2
  • HEMODYNAMICS
  • SATURATION
  • HEMOGLOBIN
  • ISCHEMIA
  • INJURY

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