Diffuse optical tomography system for acute traumatic brain injury in the intensive care unit: a prospective study on healthy volunteers

弥散光学断层扫描系统在重症监护病房急性创伤性脑损伤中的应用:一项针对健康志愿者的前瞻性研究

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Abstract

SIGNIFICANCE: Invasive neuromonitoring hinders the application of diffuse optical tomography (DOT) to critically ill adults in the intensive care unit (ICU). AIM: We aim to develop and test a method for DOT recordings suitable for traumatic brain injury (TBI) patients in the ICU. This method is based on measurements and coregistration using a 3D optical scan and the acquisition of optical data using a custom-made helmet, which would enable a multimodal (invasive and noninvasive) neuromonitoring. APPROACH: Coregistration accuracy between the method based on a 3D optical scan and one based on an electromagnetic digitization, the latter considered to be the gold standard, was assessed. The capacity to isolate and monitor, using functional near-infrared spectroscopy, the optical signal in the intracranial (ICT), and extracranial tissues (ECT), was tested on 23 healthy volunteers. Participants were scanned with a frequency-domain NIRS device (690 and 830 nm) during 5 Valsalva maneuvers (VM) in a simulated ICU environment. RESULTS: The results showed an average error of coregistration of 5.5 mm and a sufficient capacity to isolate oxyhemoglobin ( O2Hb ) ( p = 6.4 · 10-6 ) and total hemoglobin (HbT) ( p = 2.8 · 10-5 ) in the ICT from the ECT and to follow the changes of hemoglobin in the ICT during the VM ( O2Hb , p = 9.2 · 10-4 ; HbT, p = 1.0 · 10-3 ). CONCLUSION: The developed approach appears to be suitable for use on TBI patients in the ICU in a multimodal monitoring.

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