ON-LINE MONITOR OF HEPATIC PERFUSION USING FLUORESCENCE

本项目的目的是证明一种新的光谱技术用于术中和术后肝脏灌注和氧合的准确在线监测的有效性，并开发适用于临床试验的原型系统。这项新技术采用激光诱导荧光衰减光谱（LIFAS），以获得可靠的测量组织缺血在线。初步的体内实验结果证明了这种方法的可行性. I期项目的具体目标是：a）确定体内肝组织的荧光衰减光谱，B）确定减少血液灌注对肝组织荧光衰减光谱的影响。在第二阶段，我们将开发一个多变量模型，用于从测量的衰减光谱中可靠地检测肝缺血，我们将通过广泛的动物实验证明其在体内的疗效。通过适当的调整，该技术可以应用于监测其他器官和组织的缺血。所提出的技术将能够在肝脏手术期间和之后连续床旁监测肝脏组织的灌注和活力。目前，测量血液中的肝酶（转氨酶）和凝血因子（凝血酶原）是检测灌注相关肝功能障碍的唯一可靠方法，但仅在已经发生显著肝损伤后。拟定商业应用：该系统的研制成功，对肝脏手术和移植术中术后的监测具有重要的应用价值。相同的监测系统可以适用于其他器官（例如肾脏和心脏）。

The objective of this project is the demonstration of the efficacy of a new spectroscopic technique for accurate intraoperative and postoperative on- line monitoring of liver perfusion and oxygenation and the development of a prototype system appropriate for clinical trials. This novel technology employs laser induced fluorescence attenuation spectroscopy (LIFAS) to derive reliable measurements of tissue ischemia on-line. Preliminary in- vivo experimental results have demonstrated the feasibility of this approach. The specific aims of the Phase I project are: a) determine the fluorescence attenuation spectrum of hepatic tissue in-vivo, b) determine the effects of reduced blood perfusion on the fluorescence attenuation spectrum of hepatic tissue. In Phase II, we will develop a multivariate model for the reliable detection of hepatic ischernia from measured attenuation spectra, and we will demonstrate its efficacy in-vivo through extensive animal experiments. Through proper adaptation, the technique can be applied for monitoring ischemia in other organs and tissues. The proposed technique will enable the continuous bedside monitoring of the perfusion and viability of hepatic tissue during and after liver surgery. Currently, the measurement of liver enzymes (transaminases) and clotting factors (prothrombin) in the blood is the only reliable means for detecting perfusion-related hepatic dysfunction, but only after significant liver damage has already occurred. PROPOSED COMMERCIAL APPLICATION: The fully developed and tested system for on-line monitoring of hepatic perfusion will be valuable for intraoperative and postoperative monitoring in liver surgery and transplantation. The same monitoring system can be adapted for other organs (e.g. kidney and heart).