Fiber-optic monitoring of spinal cord hemodynamics in experimental aortic occlusion

Angela S. Kogler, Thomas V. Bilfinger, Robert M. Galler, Rickson C. Mesquita, Michael Cutrone, Steven S. Schenkel, Arjun G. Yodh, Thomas F. Floyd

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Spinal cord ischemia occurs frequently during thoracic aneurysm repair. Current methods based on electrophysiology techniques to detect ischemia are indirect, non-specific, and temporally slow. In this article, the authors report the testing of a spinal cord blood flow and oxygenation monitor, based on diffuse correlation and optical spectroscopies, during aortic occlusion in a sheep model. Methods: Testing was carried out in 16 Dorset sheep. Sensitivity in detecting spinal cord blood flow and oxygenation changes during aortic occlusion, pharmacologically induced hypotension and hypertension, and physiologically induced hypoxia/hypercarbia was assessed. Accuracy of the diffuse correlation spectroscopy measurements was determined via comparison with microsphere blood flow measurements. Precision was assessed through repeated measurements in response to pharmacologic interventions. Results: The fiber-optic probe can be placed percutaneously and is capable of continuously measuring spinal cord blood flow and oxygenation preoperatively, intraoperatively, and postoperatively. The device is sensitive to spinal cord blood flow and oxygenation changes associated with aortic occlusion, immediately detecting a decrease in blood flow (-65 ± 32%; n = 32) and blood oxygenation (-17 ± 13%, n = 11) in 100% of trials. Comparison of spinal cord blood flow measurements by the device with microsphere measurements led to a correlation of R2 = 0.49, P < 0.01, and the within-sheep coefficient of variation was 9.69%. Finally, diffuse correlation spectroscopy is temporally more sensitive to ischemic interventions than motor-evoked potentials. Conclusion: The first-generation spinal fiber-optic monitoring device offers a novel and potentially important step forward in the monitoring of spinal cord ischemia.

Original languageEnglish (US)
Pages (from-to)1362-1373
Number of pages12
JournalAnesthesiology
Volume123
Issue number6
DOIs
StatePublished - Dec 1 2015

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Fetal Blood
Spinal Cord
Hemodynamics
Spinal Cord Ischemia
Spectrum Analysis
Sheep
Microspheres
Equipment and Supplies
Controlled Hypotension
Motor Evoked Potentials
Hypercapnia
Electrophysiology
Aneurysm
Thorax
Ischemia
Hypertension

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Kogler, A. S., Bilfinger, T. V., Galler, R. M., Mesquita, R. C., Cutrone, M., Schenkel, S. S., ... Floyd, T. F. (2015). Fiber-optic monitoring of spinal cord hemodynamics in experimental aortic occlusion. Anesthesiology, 123(6), 1362-1373. https://doi.org/10.1097/ALN.0000000000000883

Fiber-optic monitoring of spinal cord hemodynamics in experimental aortic occlusion. / Kogler, Angela S.; Bilfinger, Thomas V.; Galler, Robert M.; Mesquita, Rickson C.; Cutrone, Michael; Schenkel, Steven S.; Yodh, Arjun G.; Floyd, Thomas F.

In: Anesthesiology, Vol. 123, No. 6, 01.12.2015, p. 1362-1373.

Research output: Contribution to journalArticle

Kogler, AS, Bilfinger, TV, Galler, RM, Mesquita, RC, Cutrone, M, Schenkel, SS, Yodh, AG & Floyd, TF 2015, 'Fiber-optic monitoring of spinal cord hemodynamics in experimental aortic occlusion', Anesthesiology, vol. 123, no. 6, pp. 1362-1373. https://doi.org/10.1097/ALN.0000000000000883
Kogler AS, Bilfinger TV, Galler RM, Mesquita RC, Cutrone M, Schenkel SS et al. Fiber-optic monitoring of spinal cord hemodynamics in experimental aortic occlusion. Anesthesiology. 2015 Dec 1;123(6):1362-1373. https://doi.org/10.1097/ALN.0000000000000883
Kogler, Angela S. ; Bilfinger, Thomas V. ; Galler, Robert M. ; Mesquita, Rickson C. ; Cutrone, Michael ; Schenkel, Steven S. ; Yodh, Arjun G. ; Floyd, Thomas F. / Fiber-optic monitoring of spinal cord hemodynamics in experimental aortic occlusion. In: Anesthesiology. 2015 ; Vol. 123, No. 6. pp. 1362-1373.
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