Feasibility of cerebral near-infrared spectroscopy monitoring in the pre-hospital environment
Feasibility of cerebral near-infrared spectroscopy monitoring in the pre-hospital environment
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DOI：
10.1111/j.1399-6576.2011.02591.x
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发表时间：
2012-02-01
影响因子：
2.1
通讯作者：
Garner, A.
中科院分区：
文献类型：
--
作者：
Weatherall, A.;Skowno, J.;Garner, A.
研究背景创伤性脑损伤（traumatic brain injury，TBI）是创伤后死亡和严重残疾的重要原因. TBI患者的院前护理可通过无创监测脑组织氧合来辅助。这项初步观察性研究旨在评估使用近红外光谱（NIRS）的脑组织血氧测定在院前和运输环境中是否可行。MethodsAfter ethics committee review，我们在健康志愿者中进行了一项可行性试验，由公路救护车或直升机运输，以评估是否可以在外部环境和患者转运过程中获得监测信号。直升机运输32架。对于室外开始的监测，66个探头中的33个（50%）提供了足够的监测信号。在公路运输方面，33次运输中有33次（100%）在70%以上的采样期内成功进行了双边监测。对于直升机运输，在使命期间，有4次运输因电池故障而中断，28次运输中有24次（85.7%）在70%以上的采样期内成功地进行了双边监测。虽然病人和运输平台的运动并没有影响监测信号，暴露于环境光提供了一个挑战，在获得监测信号，但管理与增加探头shield.ConclusionsNIRS监测是可行的，在院前环境，开辟了进一步研究的可能性，这种方式在这种情况下的作用。
BackgroundTraumatic brain injury (TBI) is a significant cause of death and severe disability from trauma. Pre‐hospital care of patients with TBI may be aided by non‐invasive monitoring of cerebral tissue oxygenation. This pilot observational study was designed to assess if cerebral tissue oximetry using near‐infrared spectroscopy (NIRS) is feasible in the pre‐hospital and transport environment.MethodsAfter ethics committee review, we undertook a feasibility trial in healthy volunteers, transported by road ambulance or helicopter, to assess if monitoring signals could be obtained in the outside environment and during patient transport.ResultsA total of 33 road ambulance transports and 32 helicopter transports were undertaken. For monitoring commenced outdoors, 33 of 66 probes applied (50%) provided adequate monitoring signal. For road transports, 33 out of 33 transports (100%) resulted in successful bilateral monitoring for more than 70% of the sampling period. For helicopter transports, four transports were cut short by battery failure during the mission and 24 of 28 transports (85.7%) resulted in successful bilateral monitoring for more than 70% of the sampling period. While patient and transport platform movement did not impact on monitoring signals, exposure to ambient light provided a challenge in obtaining monitoring signals that is nevertheless manageable with increased probe shielding.ConclusionsNIRS monitoring is feasible in the pre‐hospital environment, opening up the possibility for further research of the role of this modality in this setting.