Prolonged monitoring of cerebral blood flow and autoregulation with diffuse correlation spectroscopy in neurocritical care patients
Prolonged monitoring of cerebral blood flow and autoregulation with diffuse correlation spectroscopy in neurocritical care patients
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DOI：
10.1117/1.nph.5.4.045005
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发表时间：
2018-10-01
期刊：
影响因子：
5.3
通讯作者：
Rosenthal, Eric S.
中科院分区：
文献类型：
--
作者：
Selb, Juliette;Wu, Kuan-Cheng;Rosenthal, Eric S.
监测脑血流（CBF）和自身调节是神经危重症护理的重要组成部分，但缺乏连续的无创监测CBF的方法。漫射相关光谱（DCS）是一种非侵入性的漫射光学模式，通过监测近红外光在移动红细胞中扩散的快速波动来测量皮层微血管中的CBF指数（CBFi）。我们测试了在神经科学重症监护病房的高危患者中使用DCS监测CBFi的可行性。在临床护理允许的情况下，对6例动脉瘤性蛛网膜下腔出血患者连续获取DCS数据长达20小时。同步记录平均动脉血压，使我们能够得出自动调节曲线并计算自动调节指数。自调节曲线显示大多数患者的大脑自调节功能受到干扰，干扰的严重程度和保留的自调节功能的限度因受试者而异。我们的研究结果表明DCS模式在无创、长期监测脑灌注和自我调节方面具有潜力。(c) 2018年中国光学仪器工程师学会（SPIE）
Monitoring of cerebral blood flow (CBF) and autoregulation are essential components of neurocritical care, but continuous noninvasive methods for CBF monitoring are lacking. Diffuse correlation spectroscopy (DCS) is a noninvasive diffuse optical modality that measures a CBF index (CBFi) in the cortex microvasculature by monitoring the rapid fluctuations of near-infrared light diffusing through moving red blood cells. We tested the feasibility of monitoring CBFi with DCS in at-risk patients in the Neurosciences Intensive Care Unit. DCS data were acquired continuously for up to 20 h in six patients with aneurysmal subarachnoid hemorrhage, as permitted by clinical care. Mean arterial blood pressure was recorded synchronously, allowing us to derive autoregulation curves and to compute an autoregulation index. The autoregulation curves suggest disrupted cerebral autoregulation in most patients, with the severity of disruption and the limits of preserved autoregulation varying between subjects. Our findings suggest the potential of the DCS modality for noninvasive, long-term monitoring of cerebral perfusion, and autoregulation. (c) 2018 Society of Photo-Optical Instrumentation Engineers (SPIE)