CEREBRAL BLOOD FLOW MONITORING SYSTEM

脑血流监测系统

• 批准号: 6142589
• 负责人: GREGORY T MARTIN
• 金额: $ 9.83万
• 依托单位: THERMAL TECHNOLOGIES, INC.
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-06-01 至 2001-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6142589
• 关键词: biomedical equipment development; brain circulation; computer program /software; computer system design /evaluation; diffusion; dyes; microcapsule; neurosurgery; patient monitoring device; swine; thermometry

The long-term objective is to develop a real-time, continuous, clinical monitor of absolute cerebral blood flow (CBF). Each year in the U.S. there are 370,000 incidents of traumatic brain injury (TBI) and 100,000 subsequent deaths. Injury results from a primary trauma and a later secondary injury caused by local ischemia (deficient blood supply) in viable tissue. Monitoring and interventional therapies to prevent secondary injury attempt to maintain an adequate level of CBF to viable tissue. While in practice CBF is not typically monitored, intracranial pressure is used to indirectly assess ischemic risk. Direct, real-time and continuous monitoring of CBF will help guide therapy, provide an early warning for ischemia, vasospasm, and neurophysiologic deterioration, allow customization of patient-specific therapy and help understand neurophysiology. In Phase I, an innovative thermal method for blood flow (perfusion) measurement will be validated in swine brain against the microsphere gold standard. This thermal technique has been validated for the measurement of blood flow in liver tissue and it holds great promise as a technique to continuously monitor patient CBF in real time. Also in the Phase I, an MRI compatible neurosurgical probe will be developed. The probe will be tested in vivo for perfusion sensitivity and for its ability to quantify small changes in tissue water content (edema). PROPOSED COMMERCIAL APPLICATIONS: Over 370,000 people in the US are hospitalized for traumatic brain injury (TBI) each year and about 100,000 deaths occur per year, nationally. The total cost associated with TBI is estimated to be $48.3 billion annually: $31.7 billion associated with hospitalization and $16.6 billion associated with fatal brain injuries. Patients with subarachnoid hemorrhage, vasospasm, brain tumors and stroke are also at risk for ischemia. The proposed low cost device to quantify blood flow continuously, in real time will have significant impact on the improved management of these critically injured patients over and above the currently used, indirect indicators of cerebral blood flow.

长期目标是开发一种实时、连续、临床监测绝对脑血流（CBF）的方法。美国每年有37万起创伤性脑损伤（TBI）事件，随后有10万人死亡。损伤是由原发创伤和后来由活组织局部缺血（血液供应不足）引起的继发性损伤引起的。监测和介入治疗，以防止继发性损伤试图维持足够的CBF水平的活组织。虽然在实践中通常不监测脑血流，但颅内压用于间接评估缺血性风险。直接、实时和连续监测脑血流将有助于指导治疗，为缺血、血管痉挛和神经生理恶化提供早期预警，允许定制患者特异性治疗，并有助于了解神经生理学。在第一阶段，一种创新的热血流量（灌注）测量方法将根据微球金标准在猪脑中进行验证。该热技术已被证实可用于肝组织血流量的测量，作为一种实时连续监测患者脑血流的技术，它具有很大的前景。同样在第一阶段，将开发一种MRI兼容的神经外科探针。该探针将在体内进行灌注敏感性测试，并对组织含水量（水肿）的微小变化进行量化。拟议的商业应用：在美国，每年有超过37万人因创伤性脑损伤（TBI）住院，全国每年约有10万人死亡。据估计，每年与TBI相关的总费用为483亿美元：其中住院费用为317亿美元，致命脑损伤费用为166亿美元。蛛网膜下腔出血、血管痉挛、脑肿瘤和中风患者也有缺血的危险。所提出的低成本连续、实时量化血流量的装置，将超越目前使用的间接脑血流量指标，对改善这些危重伤员的管理产生重大影响。