Novel Non-invasive Optical Monitoring of Brain Haemodynamics and Metabolism Following Acute Brain Injury

在严重的头部损伤和脑出血之后，临床医生面临的关键困难之一是知道我们是否为受伤的大脑提供了足够的血液和氧气，以及这些氧气是否得到了有效的利用。现有的监测方法要么是有创的(涉及在大脑中插入探头)，只监测一小部分受损组织，要么不能及时提供信息，需要将不适的患者转移到远程扫描单元。近红外光谱是一种非侵入性方法，涉及通过组织照射光线，并分析光的特征以推断该组织内重要分子的浓度变化；其中两种分子是血红蛋白-参与氧气的运输-和细胞色素氧化酶-对细胞内的能量产生至关重要。我希望在健康志愿者和遭受严重脑损伤和脑出血的患者中使用一种新的近红外光谱技术组合，以观察血红蛋白和细胞色素氧化酶的变化。这些知识将有助于确定脑损伤的性质，并可能导致新的临床监测仪的发展，以指导临床治疗。

Following severe head injury and brain haemorrhage, one of the key difficulties facing clinicians is knowing whether we are supplying the injured brain with adequate levels of blood and oxygen, and knowing whether that oxygen is being used effectively. Existing methods of monitoring are either invasive (involving insertion of probes in to the brain) and only monitor a small portion of injured tissue, or do not provide information in a timely fashion, and require the dangerous transfer of unwell patients to remote scanning units.NIRS is a non-invasive method that involves shining light through tissue, and analysing the characteristics of that light to deduce changes in the concentration of important molecules within that tissue; two such molecules are haemoglobin - involved in the carriage of oxygen - and cytochrome oxidase - which is crucial to energy production within cells. I wish to use a novel combination of NIRS techniques in healthy volunteers and patients who have suffered severe head injuries and brain haemorrhages in order to look at changes in haemoglobin and cytochrome oxidase. This knowledge will be useful in characterising the nature of brain injury, and may lead to the development of new clinical monitors in order to guide clinical treatment.