Feasibility of NIRS in the neurointensive care unit: a pilot study in stroke using physiological oscillations.
Feasibility of NIRS in the neurointensive care unit: a pilot study in stroke using physiological oscillations.
复制标题
NIRS在神经强度护理单元中的可行性：使用生理振荡的中风的试点研究。
DOI：
10.1007/s12028-009-9254-4
复制
发表时间：
2009
影响因子：
3.5
通讯作者：
Schwamm, L. H.
中科院分区：
文献类型：
--
作者：
Muehlschlegel, Susanne;Selb, J.;Patel, M.;Diamond, S. G.;Franceschini, M. A.;Sorensen, A. G.;Boas, D. A.;Schwamm, L. H.
近红外光谱（NIRS）是一种无创、实时的床边模式，对脑灌注和氧合的变化敏感，对不同频率的生理振荡高度敏感。然而，NIRS的临床可行性仍然有限，部分原因是对NIRS信号定量的担忧，这主要依赖于对血红蛋白浓度和组织层的任意假设。在这项初步研究中，比较中风患者与健康对照组，我们探讨了在检测半球微血管血流动力学不对称的生理振荡过程中，半球间相关系数（IHCC）的效用。采用双半球连续波近红外光谱技术，对12例半球卒中患者和9例对照者进行了前瞻性测量。对NIRS信号进行带通滤波，以分离心脏（0.7-3 Hz）和呼吸（0.15-0.7 Hz）振荡。在两个振荡频带中计算IHCC。使用非高斯分布的Fisher Z变换，比较两组之间心脏和呼吸振荡期间的IHCC。9例患者和9例对照组的数据质量足以纳入分析。在心脏和呼吸振荡期间，患者与对照组之间的IHCC存在显著差异（心脏0.79 ± 0.18 vs. 0.94 ± 0.07，P = 0.025;呼吸0.24 ± 0.28 vs. 0.59 ± 0.3; P = 0.016）。在生理心脏和呼吸振荡期间计算IHCC可能是一种新的NIRS分析技术，用于量化神经重症监护室中风患者的不对称微血管血流动力学。它允许每个受试者作为他们自己的控制，消除了对绝对血红蛋白浓度的任意假设的需要。未来的临床应用可能包括在院前环境中快速识别缺血性脑损伤患者。这种有前途的新分析技术值得进一步验证。
Near-infrared spectroscopy (NIRS) is a non-invasive, real-time bedside modality sensitive to changes in cerebral perfusion and oxygenation and is highly sensitive to physiological oscillations at different frequencies. However, the clinical feasibility of NIRS remains limited, partly due to concerns regarding NIRS signal quantification, which relies on mostly arbitrary assumptions on hemoglobin concentrations and tissue layers. In this pilot study comparing stroke patients to healthy controls, we explored the utility of the interhemispheric correlation coefficient (IHCC) during physiological oscillations in detecting asymmetry in hemispheric microvascular hemodynamics. Using bi-hemispheric continuous-wave NIRS, 12 patients with hemispheric strokes and 9 controls were measured prospectively. NIRS signal was band-pass filtered to isolate cardiac (0.7–3 Hz) and respiratory (0.15–0.7 Hz) oscillations. IHCCs were calculated in both oscillation frequency bands. Using Fisher’s Z-transform for non-Gaussian distributions, the IHCC during cardiac and respiratory oscillations were compared between both groups. Nine patients and nine controls had data of sufficient quality to be included in the analysis. The IHCCs during cardiac and respiratory oscillations were significantly different between patients versus controls (cardiac 0.79 ± 0.18 vs. 0.94 ± 0.07, P = 0.025; respiratory 0.24 ± 0.28 vs. 0.59 ± 0.3; P = 0.016). Computing the IHCC during physiological cardiac and respiratory oscillations may be a new NIRS analysis technique to quantify asymmetric microvascular hemodynamics in stroke patients in the neurocritical care unit. It allows each subject to serve as their own control obviating the need for arbitrary assumptions on absolute hemoglobin concentration. Future clinical applications may include rapid identification of patients with ischemic brain injury in the pre-hospital setting. This promising new analysis technique warrants further validation.
登录
查看更多内容
影响因子：
5.7
作者：
Obrig, H;Neufang, M;Villringer, A
通讯作者：
Villringer, A
DOI：
10.1098/rspb.1995.0158
发表时间：
1995-09-22
影响因子：
4.7
作者：
MEEK, JH;ELWELL, CE;ZEKI, S
通讯作者：
ZEKI, S
影响因子：
4.1
作者：
Calderon-Arnulphi, Mateo;Alaraj, Ali;Charbel, Fady T.
通讯作者：
Charbel, Fady T.
影响因子：
4.4
作者：
Reinhard, Matthias;Wehrle-Wieland, Elisabeth;Hetzel, Andreas
通讯作者：
Hetzel, Andreas
影响因子：
8.3
作者：
AASLID, R;LINDEGAARD, KF;NORNES, H
通讯作者：
NORNES, H