Diffuse Optics for Acute Stroke Management

描述(由申请人提供)：缺血性中风是导致残疾的主要原因，仅在美国，预计未来50年的护理成本就高达2.2万亿美元。然而，目前的卒中管理受到无法测量潜在生理学的限制。治疗急性缺血性中风和相关脑损伤的主要目标是最大限度地增加受累区域和周围半暗带的脑血流量(CBF)。然而，由于可用于监测这类患者的CBF的工具很少，增加CBF的干预措施通常是基于对神经缺陷的预期或对临床恶化的反应而开出的经验性处方。在第一个基础研究周期中，我们的生物工程研究伙伴关系(BRP)证明了漫反射光学方法在监测脑血管生理学方面提供了独特的好处。具体地说，BRP证明了光学CBF用于卒中监测的可行性，并证实了 CBF反应。如果没有一个独特的多学科团队，这项研究就不可能进行；或者BRP团队由具有脑血管生理学和神经危重护理专业知识的临床和生物医学研究人员，以及具有光学、电子、数学和计算专业知识的物理学家和工程师组成。拟议的更新BRP已演变为包含三个核心组成部分，一个由Pi(Yodh)领导的生物医学光学小组，以及两个专注于PA大学医院(Detre)成人人口和费城儿童医院(LICht)儿科人口的临床小组。临床和技术小组相互通报开发和应用程序，揭示临床应用的新想法和对技术的新需求。拟议的研究将构建新的探头，强调设备的前端，与患者头部接触，解决阻碍大规模临床采用的重要限制；拟议的研究将扩大临床研究，以确定在其他管理模式和新的患者群体中，如符合体外膜氧合治疗条件的儿科人群中的脑血管自动调节反应，这反过来将创造更多的临床翻译机会。技术商业化和传播将由宾夕法尼亚大学技术转移中心(CTT)新兴项目主任迈克尔·波塞尔(Michael Poisel)推动。

DESCRIPTION (provided by applicant): Ischemic stroke is the leading cause of disability with $2.2 trillion in projected costs of care over the next five decades in the United States alone. However, current stroke management is limited by the inability to measure the underlying physiology. The primary goal in the management of acute ischemic stroke and related brain injury is to maximize cerebral blood flow (CBF) in the affected region and surrounding penumbra. Because of the paucity of tools available for monitoring CBF in such patients, however, interventions to augment CBF are typically prescribed empirically based on expectations of neurological deficits, or in response to clinical deterioration. In the first fundig cycle, our Bioengineering Research Partnership (BRP) demonstrated that diffuse optical methods provide unique benefits for monitoring cerebrovascular physiology. Specifically, the BRP proved feasibility of optical CBF for stroke monitoring and confirmed individual variability of CBF responses. This research could not have been carried out without a unique multi-disciplinary team; or BRP team is comprised of clinical and biomedical investigators, with expertise in cerebrovascular physiology and neurocritical care, and physical scientists and engineers with expertise in optics, electronics, mathematics and computation. The proposed renewal BRP has evolved to contain three core components, a Biomedical Optics Group led by PI (Yodh), and two Clinical Groups focused on adult populations at the Hospital of the University of PA (Detre), and pediatric populations at the Children's Hospital of Philadelphia (Licht). The clinical and technological groups cross-inform the development and application processes, uncovering new ideas for clinical applications and new demands for technology. Proposed research will construct new probe- heads which emphasize the front-end of the device, in contact with the patient head, that address important limitations that have prevented wide-scale clinical adoption, and proposed research will broaden the clinical studies to ascertain cerebrovascular autoregulation responses in other management paradigms and in new patient groups such as pediatric populations eligible for Extra-Corporeal Membrane Oxygenation therapy, which will, in turn, create more opportunities for clinical translation. Technology commercialization and dissemination will be facilitated by Michael Poisel, Director of the UPSTART program in the Center for Technology Transfer (CTT) at Penn.