Diffuse optical monitoring of peripheral tissues during uncontrolled internal hemorrhage in a porcine model.
Diffuse optical monitoring of peripheral tissues during uncontrolled internal hemorrhage in a porcine model.
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DOI：
10.1364/boe.9.000569
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发表时间：
2018-02
影响因子：
3.4
通讯作者：
K. Vishwanath;R. Gurjar;D. Wolf;S. Riccardi;M. Duggan;David R. King
中科院分区：
文献类型：
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作者：
K. Vishwanath;R. Gurjar;D. Wolf;S. Riccardi;M. Duggan;David R. King
对创伤患者进行可靠、连续和无创的血流和血红蛋白监测仍然是一个关键的目标，但通常尚未实现。两种光学传感方法-漫射相关光谱（DCS）和漫反射光谱(DRS) -用于监测和检测内出血。具体来说，我们研究了DCS和DRS在猪外周（大腿和耳垂）组织中获得的皮肤灌注测量是否可以检测出猪模型中的严重失血性休克。4只动物在闭合的腹部进行了严重的肝-门静脉损伤，导致无法控制的出血，随后允许出血10分钟，然后进行液体复苏。皮肤血流量的DRS和DCS测量是通过放置在动物大腿和耳垂上的光纤探头获得的，并从损伤前1至5分钟开始，直到休克后几分钟反复获得。在两个地点的所有动物的测量光谱中观察到明显的变化。出血时，dcs来源的皮肤血流量急剧下降，而drs来源的血管饱和度和血红蛋白与心输出量平行。所有导出的光学参数在快速出血初期都有最剧烈的变化。这表明基于DCS和DRS的联合装置可能提供一种易于使用、无创的内出血检测系统，可用于广泛的临床环境。
Reliable, continuous and noninvasive blood flow and hemoglobin monitoring in trauma patients remains a critical, but generally unachieved goal. Two optical sensing methods - diffuse correlation spectroscopy (DCS) and diffuse reflectance spectroscopy (DRS) - are used to monitor and detect internal hemorrhage. Specifically, we investigate if cutaneous perfusion measurements acquired using DCS and DRS in peripheral (thighs and ear-lobe) tissues could detect severe hemorrhagic shock in a porcine model. Four animals underwent high-grade hepato-portal injury in a closed abdomen, to induce uncontrolled hemorrhage and were subsequently allowed to bleed for 10 minutes before fluid resuscitation. DRS and DCS measurements of cutaneous blood flow were acquired using fiber optical probes placed on the thigh and earlobe of the animals and were obtained repeatedly starting from 1 to 5 minutes pre-injury, up to several minutes post shock. Clear changes were observed in measured optical spectra across all animals at both sites. DCS-derived cutaneous blood flow decreased sharply during hemorrhage, while DRS-derived vascular saturation and hemoglobin paralleled cardiac output. All derived optical parameters had the steepest changes during the rapid initial hemorrhage unambiguously. This suggests that a combined DCS and DRS based device might provide an easy-to-use, non-invasive, internal-hemorrhage detection system that can be used across a wide array of clinical settings.