TCD Post-Resuscitation Blood Flow & Edema Monitor

描述(由申请人提供)： 该项目的目的是为实现心肺复苏(CPR)后更好的结果贡献一种工具。它是对NIH计划公告PA-04-059的回应而提交的。这项提议是为了制作一种集成的多普勒超声设备来监测心脏骤停后复苏期间的脑血流和脑组织运动。这里提出的这项技术在两个方面具有很高的价值：(1)基本发现避免复苏后患者再灌注损伤的信息，(2)开发用于商业应用的复苏后监测仪，以减少目前在复苏后30天内经历的不良后果的发生率。功率M型多谱勒是这个平台的心脏，能够监测四个主要血管--两侧大脑中动脉和大脑前动脉--提供给大脑的总血流量的80%，以及这些血管附近实质中与灌流相关的运动。这一方案的创新核心是在该平台中结合了为复苏后患者的每条被监测的血管获取和存储以下信息的能力：血流速度、相对血流量、组织运动动力学(水肿)和栓塞。仪器性能将通过体模进行测试，然后将用于在心脏骤停动物模型中探索复苏后的生理学。我们的中心假设是，我们将构建的多普勒超声仪器将检测到与表明心脏骤停后复苏后损伤严重程度的已知参数相关的信号。此外，我们预计该装置将对导致急性不良后果的再灌注损伤的早期阶段更敏感。

DESCRIPTION (provided by applicant): The aim of this project is to contribute a tool towards accomplishing improved outcomes following cardiopulmonary resuscitation (CPR). It is submitted in response to NIH program announcement PA-04-059. This proposal is to prototype an integrated Doppler ultrasound device to monitor brain blood flow and brain tissue motions in the post-resuscitation period following cardiac arrest. The technology proposed here promises high value for two considerations: (1) basic discovery of information for avoiding reperfusion injury in the post-resuscitation patient, and (2) development of a post-resuscitation monitor for commercial application, to reduce incidence of adverse outcomes currently experienced in the first thirty days following resuscitation. Power M-mode Doppler comprises the heart of this platform and is capable of monitoring four major vessels-the middle and anterior cerebral arteries, bilaterally-supplying 80% of the total blood flow to the brain, as well as perfusion related motions in the parenchyma in proximity to these vessels. The innovative core of this proposal is to combine in this platform the ability to acquire and store the following information for each of the monitored vessels in the post-resuscitation patient: blood velocity, relative blood volume flow, tissue motion dynamics (edema), and embolization. Instrument performance will be tested by phantom and then will be used to explore post-resuscitation physiology in an animal model of cardiac arrest. Our central hypothesis is that the Doppler ultrasound instrument we will construct will detect signals that correlate with known parameters indicating severity of injury in the post resuscitation period following cardiac arrest. Further, we anticipate this device will be more sensitive to the early stages of reperfusion injury that lead to acute adverse outcomes.