Document Detail


Noninvasive measurement of cerebral blood flow and blood oxygenation using near-infrared and diffuse correlation spectroscopies in critically brain-injured adults.
MedLine Citation:
PMID:  19908166     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study assesses the utility of a hybrid optical instrument for noninvasive transcranial monitoring in the neurointensive care unit. The instrument is based on diffuse correlation spectroscopy (DCS) for measurement of cerebral blood flow (CBF), and near-infrared spectroscopy (NIRS) for measurement of oxy- and deoxy-hemoglobin concentration. DCS/NIRS measurements of CBF and oxygenation from frontal lobes are compared with concurrent xenon-enhanced computed tomography (XeCT) in patients during induced blood pressure changes and carbon dioxide arterial partial pressure variation.
METHODS: Seven neurocritical care patients were included in the study. Relative CBF measured by DCS (rCBF(DCS)), and changes in oxy-hemoglobin (DeltaHbO(2)), deoxy-hemoglobin (DeltaHb), and total hemoglobin concentration (DeltaTHC), measured by NIRS, were continuously monitored throughout XeCT during a baseline scan and a scan after intervention. CBF from XeCT regions-of-interest (ROIs) under the optical probes were used to calculate relative XeCT CBF (rCBF(XeCT)) and were then compared to rCBF(DCS). Spearman's rank coefficients were employed to test for associations between rCBF(DCS) and rCBF(XeCT), as well as between rCBF from both modalities and NIRS parameters.
RESULTS: rCBF(DCS) and rCBF(XeCT) showed good correlation (r (s) = 0.73, P = 0.010) across the patient cohort. Moderate correlations between rCBF(DCS) and DeltaHbO(2)/DeltaTHC were also observed. Both NIRS and DCS distinguished the effects of xenon inhalation on CBF, which varied among the patients.
CONCLUSIONS: DCS measurements of CBF and NIRS measurements of tissue blood oxygenation were successfully obtained in neurocritical care patients. The potential for DCS to provide continuous, noninvasive bedside monitoring for the purpose of CBF management and individualized care is demonstrated.
Authors:
Meeri N Kim; Turgut Durduran; Suzanne Frangos; Brian L Edlow; Erin M Buckley; Heather E Moss; Chao Zhou; Guoqiang Yu; Regine Choe; Eileen Maloney-Wilensky; Ronald L Wolf; M Sean Grady; Joel H Greenberg; Joshua M Levine; Arjun G Yodh; John A Detre; W Andrew Kofke
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurocritical care     Volume:  12     ISSN:  1556-0961     ISO Abbreviation:  Neurocrit Care     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-06-23     Revised Date:  2012-02-29    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  173-80     Citation Subset:  IM    
Affiliation:
Department of Physics and Astronomy, University of Pennsylvania, 209 South 33rd Street, Philadelphia, PA 19104, USA. meeri@sas.upenn.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Brain Injuries / diagnosis*,  physiopathology*
Brain Ischemia / diagnosis*,  physiopathology*
Cerebrovascular Circulation / physiology
Critical Care / methods*
Female
Humans
Male
Middle Aged
Oxygen / blood*
Severity of Illness Index
Spectroscopy, Near-Infrared / methods*
Subarachnoid Hemorrhage / diagnosis*,  physiopathology*
Young Adult
Grant Support
ID/Acronym/Agency:
ED-26979//PHS HHS; HL-077699/HL/NHLBI NIH HHS; NS-045839/NS/NINDS NIH HHS; NS-054575/NS/NINDS NIH HHS; NS-060653/NS/NINDS NIH HHS; R01 EB002109-15/EB/NIBIB NIH HHS; R01 NS060653-02/NS/NINDS NIH HHS; R01 NS060653-04/NS/NINDS NIH HHS; RR-02305/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
7782-44-7/Oxygen
Comments/Corrections

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