Abstract
Multimodal monitoring has been gaining traction in the critical care of patients following traumatic brain injury (TBI). Through providing a deeper understanding of the individual patient’s comprehensive physiologic state, or “physiome,” following injury, these methods hold the promise of improving personalized care and advancing precision medicine. One of the modalities being explored in TBI care is near-infrared spectroscopy (NIRS), given it’s non-invasive nature and ability to interrogate microvascular and tissue oxygen metabolism. In this narrative review, we begin by discussing the principles of NIRS technology, including spatially, frequency, and time-resolved variants. Subsequently, the applications of NIRS in various phases of clinical care following TBI are explored. These applications include the pre-hospital, intraoperative, neurocritical care, and outpatient/rehabilitation setting. The utility of NIRS to predict functional outcomes and evaluate dysfunctional cerebrovascular reactivity is also discussed. Finally, future applications and potential advancements in NIRS-based physiologic monitoring of TBI patients are presented, with a description of the potential integration with other omics biomarkers.
Highlights
Traumatic brain injury (TBI) is one of the leading causes of death and disability worldwide, with an annual incidence of approximately sixty-nine million globally (Maas et al, 2008)
near infrared spectroscopy (NIRS) technology covers a spectrum of different techniques that can be applied to monitor traumatic brain injury (TBI) patients
We aim to provide a general overview of NIRS and its potential applications in monitoring TBI patients
Summary
Traumatic brain injury (TBI) is one of the leading causes of death and disability worldwide, with an annual incidence of approximately sixty-nine million globally (Maas et al, 2008). The use of NIRS in the monitoring of TBI patients is expanding rapidly, with a recent systematic review finding it to be the most common noninvasive modality alongside transcranial Doppler ultrasonography (TCD; Roldan et al, 2020). This increased clinical adoption is likely in part due to its ease of use, noninvasive nature, and ability to provide continuous monitoring. NIRS technology covers a spectrum of different techniques that can be applied to monitor TBI patients These varying techniques can lead to confusion as the continuous biomarkers of the cerebral physiome provided by each variation are slightly different. We aim to provide a general overview of NIRS and its potential applications in monitoring TBI patients
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