Combination of optoacoustics and ultrasound imaging for non-invasive, rapid assessment, and management of circulatory shock

Abstract

We developed a noninvasive, optoacoustic diagnostic platform for monitoring of multiple physiologic variables in inpatients and outpatients. One of the most important applications of this platform is noninvasive, rapid assessment and management of circulatory shock, a common condition in critically ill patients. At present, monitoring of circulatory shock requires measurement of central venous blood oxygenation using invasive procedures such as insertion of catheters in central veins. Hemoglobin saturation below 70% in central veins indicates circulatory shock that requires immediate treatment. We built a portable optoacoustic system for noninvasive measurement of central venous oxygenation. In this study we used the optoacoustic system and clinical ultrasound imaging systems for rapid optoacoustic probing of these veins. The optoacoustic system utilizes a custom-made, sensitive optoacoustic probe that was developed in our laboratory for monitoring of blood oxygenation in deep blood vessels. The studies were performed in human subjects with different geometry (depth, size) of the veins. The ultrasound imaging systems permitted rapid identification of specific blood vessels for optoacoustic probing. We developed a novel algorithm for continuous, realtime, and precise measurement of blood oxygenation in blood vessels. Precision of central venous oxygenation measurement obtained in the study was very high: 1%. Our results indicate that the combination of optoacoustics and ultrasound imaging systems can provide more rapid and accurate assessment and management of the circulatory shock.