Continuous non-invasive optical monitoring of cerebral blood flow and oxidative metabolism after acute brain injury

Wesley B. Baker, Ramani Balu, Lian He, Venkaiah C. Kavuri, David R. Busch, Olivia Amendolia, Francis Quattrone, Suzanne Frangos, Eileen Maloney-Wilensky, Kenneth Abramson, Elizabeth Mahanna Gabrielli, Arjun G. Yodh, W. Andrew Kofke

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Rapid detection of ischemic conditions at the bedside can improve treatment of acute brain injury. In this observational study of 11 critically ill brain-injured adults, we employed a monitoring approach that interleaves time-resolved near-infrared spectroscopy (TR-NIRS) measurements of cerebral oxygen saturation and oxygen extraction fraction (OEF) with diffuse correlation spectroscopy (DCS) measurement of cerebral blood flow (CBF). Using this approach, we demonstrate the clinical promise of non-invasive, continuous optical monitoring of changes in CBF and cerebral metabolic rate of oxygen (CMRO2). In addition, the optical CBF and CMRO2 measures were compared to invasive brain tissue oxygen tension (PbtO2), thermal diffusion flowmetry CBF, and cerebral microdialysis measures obtained concurrently. The optical CBF and CMRO2 information successfully distinguished between ischemic, hypermetabolic, and hyperemic conditions that arose spontaneously during patient care. Moreover, CBF monitoring during pressor-induced changes of mean arterial blood pressure enabled assessment of cerebral autoregulation. In total, the findings suggest that this hybrid non-invasive neurometabolic optical monitor (NNOM) can facilitate clinical detection of adverse physiological changes in brain injured patients that are otherwise difficult to measure with conventional bedside monitoring techniques.

Original languageEnglish (US)
Pages (from-to)1469-1485
Number of pages17
JournalJournal of Cerebral Blood Flow and Metabolism
Volume39
Issue number8
DOIs
StatePublished - Aug 1 2019

Keywords

  • Cerebral blood flow measurement
  • intrinsic optical imaging
  • near-infrared spectroscopy
  • neurocritical care

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Baker, W. B., Balu, R., He, L., Kavuri, V. C., Busch, D. R., Amendolia, O., Quattrone, F., Frangos, S., Maloney-Wilensky, E., Abramson, K., Mahanna Gabrielli, E., Yodh, A. G., & Andrew Kofke, W. (2019). Continuous non-invasive optical monitoring of cerebral blood flow and oxidative metabolism after acute brain injury. Journal of Cerebral Blood Flow and Metabolism, 39(8), 1469-1485. https://doi.org/10.1177/0271678X19846657