Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
Towards rapid intraoperative axial localization of spinal cord ischemia with epidural diffuse correlation monitoring.
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DOI：
10.1371/journal.pone.0251271
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Floyd TF
中科院分区：
文献类型：
--
作者：
Busch DR;Lin W;Goh CC;Gao F;Larson N;Wahl J;Bilfinger TV;Yodh AG;Floyd TF
脊髓缺血导致多个手术野的医源性损伤，并且能够立即识别缺血的发作和解剖起源对其管理至关重要。然而，目前的临床监测并不直接测量脊髓血流量，导致灵敏度/特异性差、警报延迟和干预延迟。我们已经开发了一种硬膜外装置，采用扩散相关光谱（DCS）连续监测脊髓缺血在多个位置。我们研究了该器械在猪模型中定位脊髓缺血的能力，并验证了DCS与激光多普勒血流仪（LDF）的对比。具体来说，我们使用硬膜外DCS探针在纯缺血模型中连续（>0.1Hz）空间分辨（3个位置）监测脊髓血流。DCS和LDF测量的血流变化高度相关（r = 0.83）。脊髓血流量DCS测量尾侧主动脉闭塞下降62%。该监测器显示检测流量减少25%的灵敏度为0.87，特异性为0.91。这项技术可能使脊髓缺血的早期识别和至关重要的定位。
Spinal cord ischemia leads to iatrogenic injury in multiple surgical fields, and the ability to immediately identify onset and anatomic origin of ischemia is critical to its management. Current clinical monitoring, however, does not directly measure spinal cord blood flow, resulting in poor sensitivity/specificity, delayed alerts, and delayed intervention. We have developed an epidural device employing diffuse correlation spectroscopy (DCS) to monitor spinal cord ischemia continuously at multiple positions. We investigate the ability of this device to localize spinal cord ischemia in a porcine model and validate DCS versus Laser Doppler Flowmetry (LDF). Specifically, we demonstrate continuous (>0.1Hz) spatially resolved (3 locations) monitoring of spinal cord blood flow in a purely ischemic model with an epidural DCS probe. Changes in blood flow measured by DCS and LDF were highly correlated (r = 0.83). Spinal cord blood flow measured by DCS caudal to aortic occlusion decreased 62%. This monitor demonstrated a sensitivity of 0.87 and specificity of 0.91 for detection of a 25% decrease in flow. This technology may enable early identification and critically important localization of spinal cord ischemia.
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影响因子：
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作者：
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DOI：
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发表时间：
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