Monitoring Of Cerebral Blood Oxygenation Research Articles

Investigation of light propagation and detection in human head for realistic settings under clinical conditions

Investigation of light propagation and detection in human head for realistic settings under clinical conditions

Optoacoustic Monitoring of Physiologic Variables

Optoacoustic (photoacoustic) technique is a novel diagnostic platform that can be used for noninvasive measurements of physiologic variables, functional imaging, and hemodynamic monitoring. This technique is based on generation and time-resolved detection of optoacoustic (thermoelastic) waves generated in tissue by short optical pulses. This provides probing of tissues and individual blood vessels with high optical contrast and ultrasound spatial resolution. Because the optoacoustic waves carry information on tissue optical and thermophysical properties, detection, and analysis of the optoacoustic waves allow for measurements of physiologic variables with high accuracy and specificity. We proposed to use the optoacoustic technique for monitoring of a number of important physiologic variables including temperature, thermal coagulation, freezing, concentration of molecular dyes, nanoparticles, oxygenation, and hemoglobin concentration. In this review we present origin of contrast and high spatial resolution in these measurements performed with optoacoustic systems developed and built by our group. We summarize data obtained in vitro, in experimental animals, and in humans on monitoring of these physiologic variables. Our data indicate that the optoacoustic technology may be used for monitoring of cerebral blood oxygenation in patients with traumatic brain injury and in neonatal patients, central venous oxygenation monitoring, total hemoglobin concentration monitoring, hematoma detection and characterization, monitoring of temperature, and coagulation and freezing boundaries during thermotherapy.

Optoacoustic diagnostic modality: from idea to clinical studies with highly compact laser diode-based systems.

.Optoacoustic (photoacoustic) diagnostic modality is a technique that combines high optical contrast and ultrasound spatial resolution. We proposed using the optoacoustic technique for a number of applications, including cancer detection, monitoring of thermotherapy (hyperthermia, coagulation, and freezing), monitoring of cerebral blood oxygenation in patients with traumatic brain injury, neonatal patients, fetuses during late-stage labor, central venous oxygenation monitoring, and total hemoglobin concentration monitoring as well as hematoma detection and characterization. We developed and built optical parametric oscillator-based systems and multiwavelength, fiber-coupled highly compact, laser diode-based systems for optoacoustic imaging, monitoring, and sensing. To provide sufficient output pulse energy, a specially designed fiber-optic system was built and incorporated in ultrasensitive, wideband optoacoustic probes. We performed preclinical and clinical tests of the systems and the optoacoustic probes in backward mode for most of the applications and in forward mode for the breast cancer and cerebral applications. The high pulse energy and repetition rate allowed for rapid data acquisition with high signal-to-noise ratio from cerebral blood vessels, such as the superior sagittal sinus, central veins, and peripheral veins and arteries, as well as from intracranial hematomas. The optoacoustic systems were capable of automatic, real-time, continuous measurements of blood oxygenation in these blood vessels.

Pressure modulation algorithm to separate cerebral hemodynamic signals from extracerebral artifacts.

We introduce and validate a pressure measurement paradigm that reduces extracerebral contamination from superficial tissues in optical monitoring of cerebral blood flow with diffuse correlation spectroscopy (DCS). The scheme determines subject-specific contributions of extracerebral and cerebral tissues to the DCS signal by utilizing probe pressure modulation to induce variations in extracerebral blood flow. For analysis, the head is modeled as a two-layer medium and is probed with long and short source-detector separations. Then a combination of pressure modulation and a modified Beer-Lambert law for flow enables experimenters to linearly relate differential DCS signals to cerebral and extracerebral blood flow variation without a priori anatomical information. We demonstrate the algorithm's ability to isolate cerebral blood flow during a finger-tapping task and during graded scalp ischemia in healthy adults. Finally, we adapt the pressure modulation algorithm to ameliorate extracerebral contamination in monitoring of cerebral blood oxygenation and blood volume by near-infrared spectroscopy.

Noninvasive monitoring of cerebral blood oxygenation in ovine superior sagittal sinus with novel multi-wavelength optoacoustic system

Noninvasive monitoring of cerebral blood oxygenation with an optoacoustic technique offers advantages over current invasive and noninvasive methods. We report the results of in vivo studies in the sheep superior sagittal sinus (SSS), a large central cerebral vein. We changed blood oxygenation by increasing and decreasing the inspired fraction of oxygen (FiO(2)). Optoacoustic measurements from the SSS were performed at wavelengths of 700, 800, and 1064 nm using an optical parametric oscillator as a source of pulsed near-infrared light. Actual oxygenation of SSS blood was measured with a CO-Oximeter in blood samples drawn from the SSS through a small craniotomy. The amplitude of the optoacoustic signal induced in the SSS blood at lambda = 1064 nm closely followed the changes in blood oxygenation, at lambda = 800 nm was almost constant, and at lambda = 700 nm was changing in the opposite direction, all in accordance with the absorption spectra of oxy- and deoxyhemoglobin. The optoacoustically predicted oxygenation correlated well with actual blood oxygenation in sheep SSS (R(2) = 0.965 to 0.990). The accuracy was excellent, with a mean difference of 4.8% to 9.3% and a standard deviation of 2.8% to 4.2%. To the best of our knowledge, this paper reports for the first time accurate measurements of cerebral venous blood oxygenation validated against the "gold standard" CO-Oximetry method.

Intraoperative monitoring of cerebral blood oxygenation and hemodynamics during extracranial-intracranial bypass surgery by a newly developed visible light spectroscopy system

Background Cerebrovascular reconstruction procedures run the risk of changing the balance between oxygen supply and consumption during surgery. We assessed the value of visual light spectroscopy for detecting changes in cerebral blood oxygenation (CBO) during superficial temporal artery–middle cerebral artery (STA-MCA) anastomosis. Methods We developed a VLS monitoring system which permits continuous monitoring of CBO changes during surgery. Using the VLS, we evaluated the CBO changes in the MCA territory on the lesion side in 18 patients who underwent STA-MCA anastomosis. Results Temporary occlusion of the MCA (M4 portion) did not change the CBO in 17 patients. However, in the patient with dissecting aneurysm, it caused decreases of oxyhemoglobin and cortical oxygen saturation (CoS o 2) associated with an increase of deoxyhemoglobin, although these CBO changes were normalized by STA blood flow. In 5 patients, STA blood flow increased the oxyhemoglobin and CoS o 2 and decreased the deoxyhemoglobin, indicating that cortical blood flow (CoBF) was increased. The CoS o 2 before anastomosis was significantly low in the patients who showed an increase of CoS o 2 by STA blood flow (63.0% ± 2.5%) as compared with those who did not (72.0 ± 6.1%, P = .024). Conclusion Temporary occlusion of a cortical artery during bypass surgery did not affect the CBO in patients who had chronic cerebral ischemia, but caused acute ischemia in the patient who did not. STA blood flow increased the CoBF during surgery more frequently in patients who showed a low perfusion pressure. The VLS monitoring system is considered useful for evaluating bypass function and facilitates safe and accurate bypass surgery.

Non-invasive optical monitoring of cerebral blood oxygenation in the foetus and newborn: preliminary investigation

Near infra-red spectroscopy was applied as a non-invasive and continuous technique for the in vivo monitoring of blood and tissue oxygenation in human neonates. Monitoring of cerebral blood oxygenation in the wavelength range 775–904 nm was carried out on preterm infants after inducing a transient mild hypoxic change; the measurements were performed either by the transmission or reflection (backscattering) mode of monitoring. The results of these investigations were used to assess the application of the technique to foetal monitoring. A series of foetal monitoring studies was performed to investigate the influence of maternal contractions on foetal cerebral blood oxygenation. Although only changes in haemoglobin concentration can be monitored at present, the results suggest that near infra-red monitoring could provide a non-invasive, real-time monitoring method in intensive neonatal and intrapartum care.