A new biomedical device for in vivo multiparametric evaluation of tissue vitality in critical care medicine

Abstract

Real time Monitoring of mitochondrial function in vivo is a significant factor in the understanding of tissue vitality. Nevertheless a single parameter monitoring device is not appropriate and effective in clinical diagnosis of tissue vitality. Therefore we have developed a multiparameteric monitoring system that monitors, in addition to mitochondrial NADH redox state, tissue microcirculatory blood flow, tissue total back-scattered light as an indication of blood volume and blood oxygenation (Hb02). In the present communication a new device named "CritiView" is described. This device was developed in order to enable real time monitoring of the four parameters from various organs in the body. The main medical application of the CritiView is in critical care medicine of patients hospitalized in the Intensive Care Units (ICUs) and intraoperatively in operating rooms. The physiological basis for our clinical monitoring approach is based on the well known response to the development of body emergency situation, such as shock or trauma. Under such conditions a process of blood flow redistribution will give preference to vital organs (Brain, Heart) neglecting less vital organs (Skin, G-I tract or the urinary system). Under such condition the brain will be hyperperfused and 02 supply will increase to provide the need of the activated mitochondria. The non-vital organs will be hypoperfused and mitochondrial function will be inhibited leading to energy failure. This differentiation between the two types of organs could be used for the early detection of body deterioration by monitoring of the nonvital organ vitality. A fiber optic sensor was embedded in a Foley catheter, enabling the monitoring of Urethral wall vitality, to serve as an early warning signal ofbody deterioration.

Assessment of Brain Metabolic Score (BMS) In Vivo Based on Mitochondrial Activity in Neuropathology

“…In those medical environments the need for objective approach for decision making processes is very important as discussed previously [183][184][185][186][187][188][189][190][191][192][193][194][195][196][197][198][199]. In order to develop the BMS we used the multiparametric monitoring system described in detail in Figure 15 and the development of the score appeared in our publication .…”

Oxygen Homeostasis and Mitochondrial Function in COVID-19 and ARDS Patients: The Ultimate Vital Signs

“…The ultimate goal of our study is to develop the Tissue Metabolic Score (TMS) for tissues that could be monitored in the intensive care units or in the operating rooms. In order to develop the BMS/TMS we used the multiparametric monitoring system described in details and the development of the BMS/TMS appeared in our publication [77]. The device is seen in Figure 14B and the details appeared in our paper [78,79].…”

Mitochondrial function and tissue vitality: bench-to-bedside real-time optical monitoring system

“…During the research and development period, two models of the new multiparametric monitoring device were tested and submitted to the FDA for approval. The prototype of the CritiView (CRV), which was described few years ago, 9 was adapted to a single-point measurement in critical care medicine. The new model of the CRV enables one to integrate the measurements of three different locations of the tissue, thus improving the statistical basis of the measurement.…”