Optical monitoring of cerebral oxygenation in infants

婴儿脑氧合的光学监测

• 批准号: 6637858
• 负责人: Maria Angela Franceschini
• 金额: $ 35.6万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6637858
• 关键词: biomedical equipment development; brain disorder diagnosis; brain injury; cerebrovascular system; clinical biomedical equipment; clinical research; early diagnosis; human subject; infrared spectrometry; injury prevention; newborn human (0-6 weeks); oximetry; oxygen tension; oxygen transport; patient monitoring device; patient oriented research; respiratory oxygenation; swine

DESCRIPTION (provided by applicant): Oxygen deprivation, typically the result of a combination of hypoxia and hypoperfusion, is often the primary event setting off a biochemical cascade that leads to irreversible brain injury in perinatal encephalopathy. The long-term objective of this project is the development of a novel near-infrared spectroscopy (NIRS) device for the continuous monitoring of the regional tissue saturation (St02), arterial saturation (Sa02), and venous saturation (Sv02) in the neonate's brain. Such a device could potentially detect brain tissue compromise before the development of irreversible structural damage, thus allowing for timely and specific intervention. The novelty of our approach relates to the hypothesis that an appropriate temporal analysis of NIRS data can yield three different oxygenation measurements: (1) St02 from the temporal average of the optical signal; (2) Sa02 from the oscillating component of the optical absorption at the pulse frequency; (3) Sv02 from the oscillating component of the optical absorption at the respiratory frequency. The short-term goals of this project are to characterize NIRS measurements of cerebral oxygenation and to identify the most effective practical implementation of NIRS (in terms of instrumentation and data processing) for non-invasive cerebral oximetry. In particular, we aim to 1 ) investigate the relationship between the local measurements of the hemoglobin oxygenation in the cerebral tissue, in the arterial vascular compartment, and in the venous vascular compartment, and 2) perform spatially resolved measurements of cerebral oxygenation to localize areas of brain damage. To achieve our short-term goals, we propose to perform measurements on an animal model (piglets) where we can induce changes in the hemoglobin oxygenation levels over a large range, where we can perform hemodilution experiments, where we can induce focal brain injury, and where we have access to invasive readings of Sa02 and Sv02 from the gas analysis of blood samples. Finally we will test our proposed NIRS approach to cerebral oximetry on human neonates. The completion of this study will lead to the characterization of NIRS oximetry of the brain, to the development of multimode optical oximetry (simultaneous local measurement of St02, Sa02, and Sv02), and to the identification of the most effective approach to the non-invasive. continuous monitoring of cerebral oxygenation in neonates.

描述(申请人提供)：缺氧，通常是缺氧和低灌流的组合结果，通常是引发生化级联反应的主要事件，导致围产期脑病不可逆的脑损伤。该项目的长期目标是开发一种新型的近红外光谱(NIRS)设备，用于连续监测新生儿脑内局部组织饱和度(St02)、动脉饱和度(Sa02)和静脉饱和度(Sv02)。这样的设备可能会在发生不可逆转的结构损伤之前检测到脑组织受损，从而允许及时和特定的干预。我们方法的新颖之处在于，假设对近红外数据进行适当的时间分析可以得到三种不同的氧合测量结果：(1)来自光信号的时间平均值的St02；(2)来自脉冲频率处的光吸收的振荡分量的Sa02；(3)来自呼吸频率处的光吸收的振荡分量的Sv02。该项目的短期目标是确定脑血氧的近红外光谱测量的特征，并确定用于非侵入性脑氧饱和度测量的最有效的近红外光谱(在仪器和数据处理方面)的实际实施。特别是，我们的目标是1)研究局部测量脑组织、动脉和静脉血管间的血红蛋白氧合之间的关系，以及2)执行空间分辨的脑氧合测量以定位脑损伤区域。为了实现我们的短期目标，我们建议在动物模型(仔猪)上进行测量，在该模型中，我们可以在较大范围内引起血红蛋白氧合水平的变化，在该模型中，我们可以执行血液稀释实验，在该模型中，我们可以诱导局灶性脑损伤，并且我们可以从血液样本的气体分析中获得有创性的Sa02和Sv02读数。最后，我们将在人类新生儿身上测试我们提出的近红外脑氧仪方法。这项研究的完成将导致对大脑的近红外血氧仪进行表征，开发多模式光学血氧仪(同时进行St02、Sa02和Sv02的局部测量)，并确定最有效的非侵入性方法。新生儿脑氧合的连续监测。