Continuous monitoring of interstitial tissue oxygen using subcutaneous oxygen microsensors: In vivo characterization in healthy volunteers
Continuous monitoring of interstitial tissue oxygen using subcutaneous oxygen microsensors: In vivo characterization in healthy volunteers
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DOI：
10.1016/j.mvr.2019.02.002
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发表时间：
2019-07-01
影响因子：
3.1
通讯作者：
Rebrin, Kerstin
中科院分区：
文献类型：
--
作者：
Kanick, Stephen C.;Schneider, Peter A.;Rebrin, Kerstin
局部组织氧的测量可作为监测局部灌注的替代指标，并有可能指导多个临床学科的治疗决策。经皮血氧饱和度（tcpO（2））是一种市售的无创技术，使用电极加热下层皮肤组织并测量皮肤表面的氧分压。一种新的方法是使用皮下氧微传感器直接测量间质组织氧，所述皮下氧微传感器由具有嵌入式氧传感分子的生物相容性水凝胶载体平台组成。将水凝胶初始注射到皮下组织后，使用对皮肤表面基于磷光的发射的非侵入性光学测量来感测皮下间隙中的氧气。本研究的目的是表征皮下微传感器的体内性能，并与经皮血氧测定法（tcpO（2））进行比较。在7名健康志愿者的手臂上进行血管闭塞测试，在探头注射后1至10周进行重复测试，总共产生95次测试用于分析。对比分析表征了两种器械对闭塞期间组织氧减少和闭塞释放后组织氧增加的反应。结果表明：（1）微传感器和tcpO（2）返回的时间轨迹高度相关，（四分位距）相关系数r = 0.93（0.10）;（II）微传感器和tcpO（2）在闭塞期间均感知到标准化氧气的统计学显著降低（每种器械p < 0.001）;（III）微传感器检测到更快的速率变化（p < 0.001），并且在恢复期间更频繁地检测到过冲（38%对4%的测试）;（IV）测量间分析显示微传感器和tcpO之间的基线值无相关性（2）（r = 0.03），但综合氧动力学的比较显示，器械之间对闭塞的标准化反应存在相似的变化（p = 0.06），（V）测量内分析显示，微传感器检测到的生理波动大于tcpO（2）（p < 0.001），并且可以提供对诸如血管运动的过程的增强的敏感性。此外，微传感器的功能反应在注射后不同时间组（每月）之间无显著差异（p = 0.61）。尽管比较器械在感知氧气的机制上存在差异，但这些发现表明皮下氧微传感器可测量人体受试者体内间质组织氧的变化。
Measurements of regional tissue oxygen serve as a proxy to monitor local perfusion and have the potential to guide therapeutic decisions in multiple clinical disciplines. Transcutaneous oximetry (tcpO(2)) is a commercially available noninvasive technique that uses an electrode to warm underlying skin tissue and measure the resulting oxygen tension at the skin surface. A novel approach is to directly measure interstitial tissue oxygen using subcutaneous oxygen microsensors composed of a biocompatible hydrogel carrier platform with embedded oxygen sensing molecules. After initial injection of the hydrogel into subcutaneous tissue, noninvasive optical measurements of phosphorescence-based emissions at the skin surface are used to sense oxygen in the subcutaneous interstitial space. The object of the present study was to characterize the in vivo performance of subcutaneous microsensors and compare with transcutaneous oximetry (tcpO(2)). Vascular occlusion tests were performed on the arms of 7 healthy volunteers, with repeated tests occurring 1 to 10 weeks after sensor injection, yielding 95 total tests for analysis. Comparative analysis characterized the response of both devices to decreases in tissue oxygen during occlusion and to increases in tissue oxygen following release of the occlusion. Results indicated: (I) time traces returned by microsensors and tcpO(2) were highly correlated, with the median (inter quartile range) correlation coefficient of r = 0.93 (0.10); (II) both microsensors and tcpO(2) sensed a statistically significant decrease in normalized oxygen during occlusion (p < 0.001 for each device); (III) microsensors detected faster rates change (p < 0.001) and detected overshoot during recovery more frequently (38% vs. 4% of tests); (IV) inter-measurement analysis showed no correlation of baseline values between microsensors and tcpO(2) (r = 0.03), but comparison of integrated oxygen dynamics showed similar variation in the normalized response to occlusion between devices (p = 0.06), (V) intra-measurement analysis revealed that microsensors detect greater physiological fluctuations than tcpO(2) (p < 0.001) and may provide enhanced sensitivity to processes such as vasomotion. Additionally, the functional response of microsensors was not significantly different across time groupings (per month) post-injection (p = 0.61). Although the compared devices have differences in the mechanisms used to sense oxygen, these findings demonstrate that subcutaneous oxygen microsensors measure changes in interstitial tissue oxygen in human subjects in vivo.