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Francoeur CL, Lauzier F, Brassard P, Turgeon AF. Near Infrared Spectroscopy for Poor Grade Aneurysmal Subarachnoid Hemorrhage-A Concise Review. Front Neurol 2022; 13:874393. [PMID: 35518206 PMCID: PMC9062216 DOI: 10.3389/fneur.2022.874393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Delayed cerebral ischemia (DCI) disproportionately affects poor grade aneurysmal subarachnoid hemorrhage (aSAH) patients. An unreliable neurological exam and the lack of appropriate monitoring leads to unrecognized DCI, which in turn is associated with severe long-term deficits and higher mortality. Near Infrared Spectroscopy (NIRS) offers simple, continuous, real time, non-invasive cerebral monitoring. It provides regional cerebral oxygen saturation (c-rSO2), which reflects the balance between cerebral oxygen consumption and supply. Reports have demonstrated a good correlation with other cerebral oxygen and blood flow monitoring, and credible cerebrovascular reactivity indices were also derived from NIRS signals. Multiple critical c-rSO2 values have been reported in aSAH patients, based on various thresholds, duration, variation from baseline or cerebrovascular reactivity indices. Some were associated with vasospasm, some with DCI and others with clinical outcomes. However, the poor grade aSAH population has not been specifically studied and no randomized clinical trial has been published. The available literature does not support a specific NIRS-based intervention threshold to guide diagnostic or treatment in aSAH patients. We review herein the fundamental basic concepts behind NIRS technology, relationship of c-rSO2 to other brain monitoring values and their potential clinical interpretation. We follow with a critical evaluation of the use of NIRS in the aSAH population, more specifically its ability to diagnose vasospasm, to predict DCI and its association to outcome. In summary, NIRS might offer significant potential for poor grade aSAH in the future. However, current evidence does not support its use in clinical decision-making, and proper technology evaluation is required.
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Affiliation(s)
- Charles L. Francoeur
- Population Health and Optimal Health Practices Research Unit (Trauma—Emergency—Critical Care Medicine), Centre Hospitalier Universitaire (CHU) de Québec—Université Laval Research Centre, Université Laval, Québec City, QC, Canada
- Department of Anesthesiology and Critical Care, CHU de Québec—Université Laval, Critical Care Division, Québec City, QC, Canada
- Critical Care Medicine Service, CHU de Québec—Université Laval, Québec City, QC, Canada
| | - François Lauzier
- Population Health and Optimal Health Practices Research Unit (Trauma—Emergency—Critical Care Medicine), Centre Hospitalier Universitaire (CHU) de Québec—Université Laval Research Centre, Université Laval, Québec City, QC, Canada
- Department of Anesthesiology and Critical Care, CHU de Québec—Université Laval, Critical Care Division, Québec City, QC, Canada
- Critical Care Medicine Service, CHU de Québec—Université Laval, Québec City, QC, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, QC, Canada
- Research Center of the Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, QC, Canada
| | - Alexis F. Turgeon
- Population Health and Optimal Health Practices Research Unit (Trauma—Emergency—Critical Care Medicine), Centre Hospitalier Universitaire (CHU) de Québec—Université Laval Research Centre, Université Laval, Québec City, QC, Canada
- Department of Anesthesiology and Critical Care, CHU de Québec—Université Laval, Critical Care Division, Québec City, QC, Canada
- Critical Care Medicine Service, CHU de Québec—Université Laval, Québec City, QC, Canada
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Di Sieno L, Behera A, Rohilla S, Ferocino E, Contini D, Torricelli A, Krämer B, Koberling F, Pifferi A, Mora AD. Probe-hosted large area silicon photomultiplier and high-throughput timing electronics for enhanced performance time-domain functional near-infrared spectroscopy. BIOMEDICAL OPTICS EXPRESS 2020; 11:6389-6412. [PMID: 33282497 PMCID: PMC7687960 DOI: 10.1364/boe.400868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/21/2020] [Accepted: 10/07/2020] [Indexed: 05/06/2023]
Abstract
Two main bottlenecks prevent time-domain diffuse optics instruments to reach their maximum performances, namely the limited light harvesting capability of the detection chain and the bounded data throughput of the timing electronics. In this work, for the first time to our knowledge, we overcome both those limitations using a probe-hosted large area silicon photomultiplier detector coupled to high-throughput timing electronics. The system performances were assessed based on international protocols for diffuse optical imagers showing better figures with respect to a state-of-the-art device. As a first step towards applications, proof-of-principle in-vivo brain activation measurements demonstrated superior signal-to-noise ratio as compared to current technologies.
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Affiliation(s)
- L. Di Sieno
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - A. Behera
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - S. Rohilla
- PicoQuant Innovation GmbH, Rudower Chaussee 29, 12489 Berlin, Germany
- Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu and Berlin Institute of Health, Department of Internal Medicine/Infectious Diseases and Respiratory Medicine, Charitéplatz 1, 10117 Berlin, Germany
| | - E. Ferocino
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - D. Contini
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - A. Torricelli
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Fotonica e Nanotecnologie, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - B. Krämer
- PicoQuant GmbH, Rudower Chaussee 29, 12489 Berlin, Germany
| | - F. Koberling
- PicoQuant GmbH, Rudower Chaussee 29, 12489 Berlin, Germany
| | - A. Pifferi
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
- Consiglio Nazionale delle Ricerche, Istituto di Fotonica e Nanotecnologie, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
| | - A. Dalla Mora
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
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Afshari A, Ghassemi P, Lin J, Halprin M, Wang J, Mendoza G, Weininger S, Pfefer TJ. Cerebral oximetry performance testing with a 3D-printed vascular array phantom. BIOMEDICAL OPTICS EXPRESS 2019; 10:3731-3746. [PMID: 31452971 PMCID: PMC6701524 DOI: 10.1364/boe.10.003731] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 05/13/2023]
Abstract
Cerebral oximetry based on near-infrared spectroscopy represents a unique noninvasive tool for real-time surgical monitoring, yet studies have shown a significant discrepancy in accuracy among commercial systems. Towards the establishment of a standardized method for performance testing, we have studied a solid phantom approach - based on a 3D-printed cerebrovascular module (CVM) incorporating an array of 148 cylindrical channels - that has several advantages over liquid phantoms. Development and characterization of a CVM prototype are described, including high-resolution imaging and spectrophotometry measurements. The CVM was filled with whole bovine blood tuned over an oxygen saturation range of 30-90% and molded-silicone layers simulating extracerebral tissues were used to evaluate penetration depth. Saturation measurement accuracy was assessed in two commercially-available clinical cerebral oximeters. For one oximeter, both neonatal and pediatric sensors showed a high degree of precision, whereas accuracy was strongly dependent on saturation level and extracerebral geometry. The second oximeter showed worse precision, yet greater robustness to variations in extracerebral layers. These results indicate that 3D-printed channel array phantoms represent a promising new approach for standardized testing of clinical oximeters.
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Wang J, Lin J, Chen Y, Welle CG, Pfefer TJ. Phantom-based evaluation of near-infrared intracranial hematoma detector performance. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-10. [PMID: 30989838 PMCID: PMC6989771 DOI: 10.1117/1.jbo.24.4.045001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 03/20/2019] [Indexed: 05/29/2023]
Abstract
Near-infrared spectroscopy (NIRS) is emerging as a rapid, low-cost approach for point-of-care triage of hematomas resulting from traumatic brain injury. However, there remains a lack of standardized test methods for benchtop performance assessment of these devices and incomplete understanding of relevant light-tissue interactions. We propose a phantom-based test method for systems operating near the 800-nm oxy-/deoxy-hemoglobin isosbestic point and implement it to evaluate a clinical system. Semi-idealized phantom geometries are designed to represent epidural/subdural, subarachnoid, and intracerebral hemorrhages. Measurements of these phantoms are made with a commercial NIRS-based hematoma detector to quantify the effect of hematoma type, depth, and size, as well as measurement repeatability and detector positioning relative to the hematoma. Results indicated high sensitivity to epidural/subdural and subarachnoid hematomas. Intracerebral hematomas are detectable to a maximum depth of ∼2.5 cm, depending on thickness and diameter. The maximum lateral detection area for the single-emitter/single-collector device studied here appears elliptical and decreases strongly with inclusion depth. Overall, this study provides unique insights into hematoma detector function and indicates the utility of modular polymer tissue phantoms in performance tests for emerging NIRS-based cerebral diagnostic technology.
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Affiliation(s)
- Jianting Wang
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, Maryland, United States
| | - Jonathan Lin
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, Maryland, United States
| | - Yu Chen
- University of Maryland, Fischell Department of Bioengineering, College Park, Maryland, United States
| | - Cristin G. Welle
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, Maryland, United States
- University of Colorado, Department of Neurosurgery and Bioengineering, Aurora, Colorado, United States
| | - T. Joshua Pfefer
- U.S. Food and Drug Administration, Center for Devices and Radiological Health, Silver Spring, Maryland, United States
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Caccioppola A, Carbonara M, Macrì M, Longhi L, Magnoni S, Ortolano F, Triulzi F, Zanier ER, Zoerle T, Stocchetti N. Ultrasound-tagged near-infrared spectroscopy does not disclose absent cerebral circulation in brain-dead adults. Br J Anaesth 2018; 121:588-594. [PMID: 30115257 DOI: 10.1016/j.bja.2018.04.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 04/09/2018] [Accepted: 05/04/2018] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND Near-infrared spectroscopy, a non-invasive technique for monitoring cerebral oxygenation, is widely used, but its accuracy is questioned because of the possibility of extra-cranial contamination. Ultrasound-tagged near-infrared spectroscopy (UT-NIRS) has been proposed as an improvement over previous methods. We investigated UT-NIRS in healthy volunteers and in brain-dead patients. METHODS We studied 20 healthy volunteers and 20 brain-dead patients with two UT-NIRS devices, CerOx™ and c-FLOW™ (Ornim Medical, Kfar Saba, Israel), which measure cerebral flow index (CFI), a parameter related to changes in cerebral blood flow (CBF). Monitoring started after the patients had been declared brain dead for a median of 34 (range: 11-300) min. In 11 cases, we obtained further demonstration of absent CBF. RESULTS In healthy volunteers, CFI was markedly different in the two hemispheres in the same subject, with wide variability amongst subjects. In brain-dead patients (median age: 64 yr old, 45% female; 20% traumatic brain injury, 40% subarachnoid haemorrhage, and 40% intracranial haemorrhage), the median (inter-quartile range) CFI was 41 (36-47), significantly higher than in volunteers (33; 27-36). CONCLUSIONS In brain-dead patients, where CBF is absent, the UT-NIRS findings can indicate an apparently perfused brain. This might reflect an insufficient separation of signals from extra-cranial structures from a genuine appraisal of cerebral perfusion. For non-invasive assessment of CBF-related parameters, the near-infrared spectroscopy still needs substantial improvement.
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Affiliation(s)
- A Caccioppola
- Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - M Carbonara
- Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - M Macrì
- Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - L Longhi
- Neurosurgical Intensive Care Unit, Department of Anesthesia and Critical Care Medicine, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - S Magnoni
- Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - F Ortolano
- Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - F Triulzi
- Department of Neuroradiology, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - E R Zanier
- Department of Neuroscience, Laboratory of Acute Brain Injury and Therapeutic Strategies, IRCCS Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - T Zoerle
- Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - N Stocchetti
- Neuroscience Intensive Care Unit, Department of Anesthesia and Critical Care, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
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6
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Giacalone G, Zanoletti M, Contini D, Re R, Spinelli L, Roveri L, Torricelli A. Cerebral time domain-NIRS: reproducibility analysis, optical properties, hemoglobin species and tissue oxygen saturation in a cohort of adult subjects. BIOMEDICAL OPTICS EXPRESS 2017; 8:4987-5000. [PMID: 29188096 PMCID: PMC5695946 DOI: 10.1364/boe.8.004987] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 09/14/2017] [Accepted: 09/22/2017] [Indexed: 05/20/2023]
Abstract
The reproducibility of cerebral time-domain near-infrared spectroscopy (TD-NIRS) has not been investigated so far. Besides, reference intervals of cerebral optical properties, of absolute concentrations of deoxygenated-hemoglobin (HbR), oxygenated-hemoglobin (HbO), total hemoglobin (HbT) and tissue oxygen saturation (StO2) and their variability have not been reported. We have addressed these issues on a sample of 88 adult healthy subjects. TD-NIRS measurements at 690, 785, 830 nm were fitted with the diffusion model for semi-infinite homogenous media. Reproducibility, performed on 3 measurements at 5 minutes intervals, ranges from 1.8 to 6.9% for each of the hemoglobin species. The mean ± SD global values of HbR, HbO, HbT, StO2 are respectively 24 ± 7 μM, 33.3 ± 9.5 μM, 57.4 ± 15.8 μM, 58 ± 4.2%. StO2 displays the narrowest range of variability across brain regions.
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Affiliation(s)
- Giacomo Giacalone
- San Raffaele Scientific Institute, Neurology Department, Via Olgettina 60, 20132, Milan, Italy
- University “Vita-Salute” San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Marta Zanoletti
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Davide Contini
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Rebecca Re
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Lorenzo Spinelli
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Luisa Roveri
- San Raffaele Scientific Institute, Neurology Department, Via Olgettina 60, 20132, Milan, Italy
- University “Vita-Salute” San Raffaele, Via Olgettina 60, 20132, Milan, Italy
- These authors contributed equally to this paper
| | - Alessandro Torricelli
- Politecnico di Milano, Dipartimento di Fisica, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
- Istituto di Fotonica e Nanotecnologie, Consiglio Nazionale delle Ricerche, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
- These authors contributed equally to this paper
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Weigl W, Milej D, Janusek D, Wojtkiewicz S, Sawosz P, Kacprzak M, Gerega A, Maniewski R, Liebert A. Application of optical methods in the monitoring of traumatic brain injury: A review. J Cereb Blood Flow Metab 2016; 36:1825-1843. [PMID: 27604312 PMCID: PMC5094301 DOI: 10.1177/0271678x16667953] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/28/2016] [Accepted: 07/18/2016] [Indexed: 01/19/2023]
Abstract
We present an overview of the wide range of potential applications of optical methods for monitoring traumatic brain injury. The MEDLINE database was electronically searched with the following search terms: "traumatic brain injury," "head injury," or "head trauma," and "optical methods," "NIRS," "near-infrared spectroscopy," "cerebral oxygenation," or "cerebral oximetry." Original reports concerning human subjects published from January 1980 to June 2015 in English were analyzed. Fifty-four studies met our inclusion criteria. Optical methods have been tested for detection of intracranial lesions, monitoring brain oxygenation, assessment of brain perfusion, and evaluation of cerebral autoregulation or intracellular metabolic processes in the brain. Some studies have also examined the applicability of optical methods during the recovery phase of traumatic brain injury . The limitations of currently available optical methods and promising directions of future development are described in this review. Considering the outstanding technical challenges, the limited number of patients studied, and the mixed results and opinions gathered from other reviews on this subject, we believe that optical methods must remain primarily research tools for the present. More studies are needed to gain confidence in the use of these techniques for neuromonitoring of traumatic brain injury patients.
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Affiliation(s)
- Wojciech Weigl
- Department of Surgical Sciences/Anaesthesiology and Intensive Care, Uppsala University, Akademiska Hospital, Uppsala, Sweden
| | - Daniel Milej
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Dariusz Janusek
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Stanisław Wojtkiewicz
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Piotr Sawosz
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Michał Kacprzak
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Anna Gerega
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Roman Maniewski
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
| | - Adam Liebert
- Nalecz Institute of Biocybernetics and Biomedical Engineering, Polish Academy of Sciences, Warsaw, Poland
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8
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Davies DJ, Clancy M, Lighter D, Balanos GM, Lucas SJE, Dehghani H, Su Z, Forcione M, Belli A. Frequency-domain vs continuous-wave near-infrared spectroscopy devices: a comparison of clinically viable monitors in controlled hypoxia. J Clin Monit Comput 2016; 31:967-974. [PMID: 27778208 PMCID: PMC5599440 DOI: 10.1007/s10877-016-9942-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 10/07/2016] [Indexed: 11/13/2022]
Abstract
The Near-infrared spectroscopy (NIRS) has not been adopted as a mainstream monitoring modality in acute neurosurgical care due to concerns about its reliability and consistency. However, improvements in NIRS parameter recovery techniques are now available that may improve the quantitative accuracy of NIRS for this clinical context. Therefore, the aim of this study was to compare the abilities of a continuous-wave (CW) NIRS device with a similarly clinically viable NIRS device utilising a frequency-domain (FD) parameter recovery technique in detecting changes in cerebral tissue saturation during stepwise increases of experimentally induced hypoxia. Nine healthy individuals (6M/3F) underwent a dynamic end-tidal forced manipulation of their expiratory gases to induce a stepwise induced hypoxia. The minimum end-tidal oxygen partial pressure (EtO2) achieved was 40 mm Hg. Simultaneous neurological and extra-cranial tissue NIRS reading were obtained during this protocol by both tested devices. Both devices detected significant changes in cerebral tissue saturation during the induction of hypoxia (CW 9.8 ± 2.3 %; FD 7.0 ± 3.4 %; Wilcoxon signed rank test P < 0.01 for both devices). No significant difference was observed between the saturation changes observed by either device (P = 0.625). An observably greater degree of noise was noticed in parameters recovered by the FD device, and both demonstrated equally variable baseline readings (Coefficient of variance 8.4 and 9.7 % for the CW and FD devices, respectively) between individuals tested. No advantageous difference was observed in parameters recovered from the FD device compared with those detected by CW.
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Affiliation(s)
- David James Davies
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), University Hospitals Birmingham NHS Foundation Trust, Heritage Building (Old Queen Elizabeth Hospital), Edgbaston, Birmingham, B15 2TH, UK. .,Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
| | - Michael Clancy
- PSIBS Doctoral Training Centre, University of Birmingham, Birmingham, UK
| | - Daniel Lighter
- School of Chemistry, University of Birmingham, Birmingham, UK
| | - George M Balanos
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Samuel John Edwin Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Hamid Dehghani
- PSIBS Doctoral Training Centre, University of Birmingham, Birmingham, UK
| | - Zhangjie Su
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), University Hospitals Birmingham NHS Foundation Trust, Heritage Building (Old Queen Elizabeth Hospital), Edgbaston, Birmingham, B15 2TH, UK.,School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
| | - Mario Forcione
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Antonio Belli
- National Institute for Health Research Surgical Reconstruction and Microbiology Research Centre (NIHR SRMRC), University Hospitals Birmingham NHS Foundation Trust, Heritage Building (Old Queen Elizabeth Hospital), Edgbaston, Birmingham, B15 2TH, UK.,Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,School of Clinical and Experimental Medicine, University of Birmingham, Birmingham, UK
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9
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Lin BS, Wang CC, Chang MH, Chio CC. Evaluation of traumatic brain injury by optical technique. BMC Neurol 2015; 15:202. [PMID: 26467307 PMCID: PMC4606549 DOI: 10.1186/s12883-015-0465-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 10/06/2015] [Indexed: 12/27/2022] Open
Abstract
Background Traumatic brain injury (TBI), usually due to brain shaking or impact, affects the normal brain function and may lead to severe disability or even death. However, there is paucity of information regarding changes in the physiologic state of humans or animals after brain shaking. Methods In this study, near-infrared spectroscopy (NIRS) was used to continuously monitor the concentration change of oxy-hemoglobin (HbO2) and deoxy-hemoglobin (HbR) to understand changes in the physiological state during and after brain shaking. Laser Doppler flowmetry was also used to monitor changes in cerebral blood flow under TBI to supplement the investigation. Triphenyltetrazolium chloride (TTC) staining was used to monitor changes of infarction volume corresponding to different impact strengths. Result The experimental results indicated that concentration changes of HbO2 and total-hemoglobin (HbT) were significantly related to the impact strength. The infarction volume was also significantly related to the impact strength. Conclusion Therefore, the non-invasive monitoring of concentration changes in HbO2, HbR, and HbT using NIRS may have a clinical application for the evaluation of TBI.
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Affiliation(s)
- Bor-Shyh Lin
- Institute of Imaging and Biomedical Photonics, National Chiao-Tung University, Tainan, Taiwan. .,Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
| | - Che-Chuan Wang
- Institute of Photonic System, National Chiao-Tung University, No.901, Zhonghua Rd., Yongkang Dist., Tainan, 710, Taiwan. .,Division of Neurosurgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan. .,Department of Child Care, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
| | - Ming-Hsien Chang
- Institute of Imaging and Biomedical Photonics, National Chiao-Tung University, Tainan, Taiwan.
| | - Chung-Ching Chio
- Division of Neurosurgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.
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10
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Mora AD, Martinenghi E, Contini D, Tosi A, Boso G, Durduran T, Arridge S, Martelli F, Farina A, Torricelli A, Pifferi A. Fast silicon photomultiplier improves signal harvesting and reduces complexity in time-domain diffuse optics. OPTICS EXPRESS 2015; 23:13937-46. [PMID: 26072763 DOI: 10.1364/oe.23.013937] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
We present a proof of concept prototype of a time-domain diffuse optics probe exploiting a fast Silicon PhotoMultiplier (SiPM), featuring a timing resolution better than 80 ps, a fast tail with just 90 ps decay time-constant and a wide active area of 1 mm2. The detector is hosted into the probe and used in direct contact with the sample under investigation, thus providing high harvesting efficiency by exploiting the whole SiPM numerical aperture and also reducing complexity by avoiding the use of cumbersome fiber bundles. Our tests also demonstrate high accuracy and linearity in retrieving the optical properties and suitable contrast and depth sensitivity for detecting localized inhomogeneities. In addition to a strong improvement in both instrumentation cost and size with respect to legacy solutions, the setup performances are comparable to those of state-of-the-art time-domain instrumentation, thus opening a new way to compact, low-cost and high-performance time-resolved devices for diffuse optical imaging and spectroscopy.
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11
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Blohm ME, Obrecht D, Hartwich J, Singer D. Effect of cerebral circulatory arrest on cerebral near-infrared spectroscopy in pediatric patients. Paediatr Anaesth 2014; 24:393-9. [PMID: 24354795 DOI: 10.1111/pan.12328] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND/AIMS The aim was to investigate whether cerebral transcutaneous near-infrared spectroscopy (NIRS) or two-site NIRS is a suitable monitoring tool to detect or confirm a cerebral circulatory arrest in pediatric intensive care unit (PICU) patients. METHODS Prospective single-center pediatric observational study. Simultaneous NIRS measurements over forehead (cNIRS, crS02) and kidney (rNIRS, rrSO2), at the same time, the cardiac output were determined by transthoracic echocardiography. Area under the curve (AUC) in the receiver-operating curve (ROC) was analyzed for NIRS regarding cerebral circulatory arrest. RESULTS There were two groups of patients (weight 2.1-73 kg): Group A: patients with intact cerebral perfusion (n = 36). Group B: patients with cerebral circulatory arrest (n = 8) proven by Doppler ultrasound scan or perfusion scintigraphy. There was no difference in cardiac output between the groups. PICU mortality for Group A was 3/36 (8.3%), for Group B 8/8, (100%). Mean cNIRS values were significantly higher with 68.92 (SEM = 2.54, SD = 15.25) in Group A compared with 34.63 (SEM = 5.36, SD = 15.15) in Group B (P < 0.001). ROC analysis for cNIRS detecting cerebral circulatory arrest was significant (AUC 0.948, 95% confidence interval 0.876-1.000, SE = 0.037, P < 0.001). Discrimination was optimal at 46 for cNIRS, at 36.5 for the difference rNIRS-cNIRS and at 0.5646 for the quotient cNIRS/rNIRS. The probability of a cerebral circulatory arrest was 77.8% (cNIRS) and 87.5% (combinations of cNIRS and rNIRS) at these cutoffs. CONCLUSIONS cNIRS did detect cerebral circulatory arrest with high sensitivity. Specificity was, however, not high enough to confirm a cerebral circulatory arrest.
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Affiliation(s)
- Martin E Blohm
- Department of Pediatrics, Division of Neonatology and Pediatric Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Torricelli A, Contini D, Pifferi A, Caffini M, Re R, Zucchelli L, Spinelli L. Time domain functional NIRS imaging for human brain mapping. Neuroimage 2014; 85 Pt 1:28-50. [DOI: 10.1016/j.neuroimage.2013.05.106] [Citation(s) in RCA: 294] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 04/25/2013] [Accepted: 05/21/2013] [Indexed: 02/02/2023] Open
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