Optical measurement of cellular oxygenation in shock and resuscitation

描述(申请人提供)：危重患者可能会死于多器官功能障碍综合征(MODS)，尽管他们的血压，动脉氧合和血液酸碱状态已经恢复。间接证据表明，细胞缺氧是导致这些患者死亡的最初损伤。这是一项修订后的提案，旨在开发一种非侵入性血氧仪来测量骨骼肌细胞的氧合。脉搏血氧仪通过提供动脉血氧饱和度的非侵入性测量，使重症监护发生了革命性的变化。本应用的创新目标是进入下一步，开发一种通过测定细胞内肌红蛋白氧饱和度来非侵入性测量骨骼肌细胞氧合的仪器。给出了初步数据，验证了该方法的可行性。提出了一个研究计划，其中一种新的光学光谱分析方法--多元曲线分辨率(MCR)被优化以考虑组织中的光散射。该方法将通过使用磁共振波谱(MRS)对肌红蛋白饱和度的独立测量来验证。该仪器的实用性将在麻醉兔失血性休克模型中进行测试。非侵入性监测骨骼肌细胞缺氧的能力在危重患者的治疗中具有巨大的潜力。 公共卫生相关性：该项目将开发和测试一种评估骨骼肌细胞氧合作用的新方法。在创伤性休克的动物模型中，这种方法分析通过皮肤反射的光的光谱或颜色变化，以确定氧气进入肌肉细胞的程度。这一新方法可能提供重要的新信息，可用于改进目前对创伤性损伤所致休克患者的治疗。

DESCRIPTION (provided by applicant): Critically ill patients may die of Multiple Organ Dysfunction Syndrome (MODS) despite having their blood pressure, arterial oxygenation, and blood acid base status restored. Indirect evidence indicates that cellular hypoxia is the initial injury leading to death in these patients. This is a revised proposal to develop a noninvasive oximeter to measure skeletal muscle cellular oxygenation. Pulse oximetry revolutionized critical care by providing a noninvasive measurement of arterial hemoglobin oxygen saturation. The innovative goal of the present application is to go the next step and develop an instrument for noninvasively measuring skeletal muscle cellular oxygenation by determining intracellular myoglobin oxygen saturation. Preliminary data are presented that demonstrate the feasibility of the method. A research plan is proposed where a novel optical spectral analysis method, Multivariate Curve Resolution (MCR), is optimized to account for light scattering in tissue. The method will be validated by an independent measure of myoglobin saturation using Magnetic Resonance Spectroscopy (MRS). The utility of the instrument will be tested in a model of hemorrhagic shock in anesthetized rabbits. The ability to noninvasively monitor skeletal muscle cellular hypoxia has enormous potential for the treatment of critically ill patients. PUBLIC HEALTH RELEVANCE: This project will develop and test a new approach to assess cellular oxygenation in skeletal muscle. The approach analyzes spectral, or color changes from reflected light through the skin to determine how well oxygen is able to get into muscle cells, in an animal model of traumatic shock. This new approach may provide crucial new information that can be used for improving current therapies for people in shock, resulting from traumatic injuries.