Hyperspectral Imaging for the Evaluation of Microcirculatory Tissue Oxygenation and Perfusion Quality in Haemorrhagic Shock: A Porcine Study.

Maximilian Dietrich,Daniel Gruneberg,Alexander Studier-Fischer,Berkin Özdemir,Beat Peter Müller-Stich,Thorsten Brenner,Florian Uhle,Felix Nickel,Maik Von Der Forst,Mascha O Fiedler,Felix C F Schmitt,Karsten Schmidt,Clara Petersen,Markus A Weigand

doi:10.3390/biomedicines9121829

Maximilian Dietrich, Daniel Gruneberg + Show 12 more

Open Access

https://doi.org/10.3390/biomedicines9121829

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Abstract

Background: The ultimate goal of haemodynamic therapy is to improve microcirculatory tissue and organ perfusion. Hyperspectral imaging (HSI) has the potential to enable noninvasive microcirculatory monitoring at bedside. Methods: HSI (Tivita® Tissue System) measurements of tissue oxygenation, haemoglobin, and water content in the skin (ear) and kidney were evaluated in a double-hit porcine model of major abdominal surgery and haemorrhagic shock. Animals of the control group (n = 7) did not receive any resuscitation regime. The interventional groups were treated exclusively with either crystalloid (n = 8) or continuous norepinephrine infusion (n = 7). Results: Haemorrhagic shock led to a drop in tissue oxygenation parameters in all groups. These correlated with established indirect markers of tissue oxygenation. Fluid therapy restored tissue oxygenation parameters. Skin and kidney measurements correlated well. High dose norepinephrine therapy deteriorated tissue oxygenation. Tissue water content increased both in the skin and the kidney in response to fluid therapy. Conclusions: HSI detected dynamic changes in tissue oxygenation and perfusion quality during shock and was able to indicate resuscitation effectivity. The observed correlation between HSI skin and kidney measurements may offer an estimation of organ oxygenation impairment from skin monitoring. HSI microcirculatory monitoring could open up new opportunities for the guidance of haemodynamic management.

Highlights

Licensee MDPI, Basel, Switzerland.Haemodynamic therapy aims to maintain tissue perfusion and oxygen delivery to protect organ function during phases of circulatory compromise [1]
In a double-hit porcine model of major abdominal surgery and haemorrhagic shock, we aimed to evaluate whether Hyperspectral imaging (HSI) can detect pathological skin and kidney tissue oxygenation and perfusion deficits, the response to fluid and vasopressor therapy, and detrimental resuscitation side effects
We propose that intraoperative HSI skin monitoring alone or combined with organ measurements in the surgical field could be used as a surrogate for appropriate tissue oxygen supply

Summary

Introduction

Licensee MDPI, Basel, Switzerland.Haemodynamic therapy aims to maintain tissue perfusion and oxygen delivery to protect organ function during phases of circulatory compromise [1]. A prerequisite for effective resuscitation therapy is haemodynamic coherence, in which attaining macrohaemodynamic target parameters translates into the restoration of sufficient microcirculatory perfusion and tissue oxygenation [2]. The ultimate goal of haemodynamic therapy is to improve microcirculatory tissue and organ perfusion. Methods: HSI (Tivita® Tissue System) measurements of tissue oxygenation, haemoglobin, and water content in the skin (ear) and kidney were evaluated in a double-hit porcine model of major abdominal surgery and haemorrhagic shock. Results: Haemorrhagic shock led to a drop in tissue oxygenation parameters in all groups. These correlated with established indirect markers of tissue oxygenation. The observed correlation between HSI skin and kidney measurements may offer an estimation of organ oxygenation impairment from skin monitoring. HSI microcirculatory monitoring could open up new opportunities for the guidance of haemodynamic management

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