Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy: erratum

Ruesch, Alexander; Yang, Jason; Schmitt, Samantha; Acharya, Deepshikha; Smith, Matthew A.; Kainerstorfer, Jana M.

doi:10.1364/boe.452731

Cited by 5 publications

(7 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A source of uncertainty in this initial optical approach is the necessity for arterial blood pressure pulsatility measurements, which were estimated by systolic and diastolic cuff measurements. Application of advanced machine learning models may enable ICP prediction based on standalone DCS BFI or FD DOS measurements of trends in oxyhemoglobin, deoxyhemoglobin, and total hemoglobin concentrations [ 252 , 253 , 256 ]. These results highlight the feasibility and potential utility for a point-of-care noninvasive optical assessment of ICP in emergent settings and as a continuous bedside monitor to improve detection and management of intracranial hypertension.…”

Section: Advances In Neuromonitoringmentioning

confidence: 99%

Advanced Neuromonitoring Modalities on the Horizon: Detection and Management of Acute Brain Injury in Children

Catennacio

Shin

et al. 2023

Neurocrit Care

View full text Add to dashboard Cite

Timely detection and monitoring of acute brain injury in children is essential to mitigate causes of injury and prevent secondary insults. Increasing survival in critically ill children has emphasized the importance of neuroprotective management strategies for long-term quality of life. In emergent and critical care settings, traditional neuroimaging modalities, such as computed tomography and magnetic resonance imaging (MRI), remain frontline diagnostic techniques to detect acute brain injury. Although detection of structural and anatomical abnormalities remains crucial, advanced MRI sequences assessing functional alterations in cerebral physiology provide unique diagnostic utility. Head ultrasound has emerged as a portable neuroimaging modality for point-of-care diagnosis via assessments of anatomical and perfusion abnormalities. Application of electroencephalography and near-infrared spectroscopy provides the opportunity for real-time detection and goal-directed management of neurological abnormalities at the bedside. In this review, we describe recent technological advancements in these neurodiagnostic modalities and elaborate on their current and potential utility in the detection and management of acute brain injury.

show abstract

Section: Advances In Neuromonitoringmentioning

confidence: 99%

Advanced Neuromonitoring Modalities on the Horizon: Detection and Management of Acute Brain Injury in Children

Catennacio

Shin

et al. 2023

Neurocrit Care

View full text Add to dashboard Cite

show abstract

“…These statistics were calculated from pairs of observations (invasive and non-invasive ICP), treating each pair as an independent measurement. The latter is to ensure comparability of our results with other publications in the field, where AI models have been created from optical cerebral measurements to estimate ICP [ 30 , 39 , 46 ]. Nonetheless, the AI and statistical techniques applied have not been adjusted for the extensive number of repeated measurements per patient.…”

Section: Methodsmentioning

confidence: 83%

“…have been working with NIRS and diffuse correlation spectroscopy (DCS) technologies to estimate ICP non-invasively. The authors present a recompilation of studies where ICP changes were induced incrementally (from about 3–10 mmHg up to 40 mmHg in steps of 10 mmHg) through fluid infusion in non-human primates ( n = 5 to 8) [ 30 , 39 , 46 ]. These studies utilised the cardiac pulse acquired by DCS in a similar way to how this pilot trial used cerebral PPG signals.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, Ruesh’s approach relies on incorporating ECG measurements for pulse detection in the DCS signals, which is not needed by the PPG method as these signals are synchronised to the heart cycle. Moreover, Ruesh’s method is not entirely non-invasive, as it utilises MAP measurements from an arteria line to estimate ICP [ 30 , 39 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients

Roldan,

Abay,

Uff

et al. 2024

Acta Neurochir

View full text Add to dashboard Cite

Purpose In this research, a non-invasive intracranial pressure (nICP) optical sensor was developed and evaluated in a clinical pilot study. The technology relied on infrared light to probe brain tissue, using photodetectors to capture backscattered light modulated by vascular pulsations within the brain’s vascular tissue. The underlying hypothesis was that changes in extramural arterial pressure could affect the morphology of recorded optical signals (photoplethysmograms, or PPGs), and analysing these signals with a custom algorithm could enable the non-invasive calculation of intracranial pressure (nICP). Methods This pilot study was the first to evaluate the nICP probe alongside invasive ICP monitoring as a gold standard. nICP monitoring occurred in 40 patients undergoing invasive ICP monitoring, with data randomly split for machine learning. Quality PPG signals were extracted and analysed for time-based features. The study employed Bland–Altman analysis and ROC curve calculations to assess nICP accuracy compared to invasive ICP data. Results Successful acquisition of cerebral PPG signals from traumatic brain injury (TBI) patients allowed for the development of a bagging tree model to estimate nICP non-invasively. The nICP estimation exhibited 95% limits of agreement of 3.8 mmHg with minimal bias and a correlation of 0.8254 with invasive ICP monitoring. ROC curve analysis showed strong diagnostic capability with 80% sensitivity and 89% specificity. Conclusion The clinical evaluation of this innovative optical nICP sensor revealed its ability to estimate ICP non-invasively with acceptable and clinically useful accuracy. This breakthrough opens the door to further technological refinement and larger-scale clinical studies in the future. Trial registration NCT05632302, 11th November 2022, retrospectively registered.

show abstract

“…Diffuse optics methods (including NIRS and DCS) may provide a viable non-invasive method for ICP measurement. Early studies have examined their use in non-human primate (NHP) models 106 , 107 as well as in infants, 108 by estimating ICP from the derived cardiac waveform 106 and comparing this to the gold-standard invasive monitors. Importantly, alterations to relative [HbO] alone (which can be obtained with basic NIRS devices) appear to change with ICP and when used in combination with machine learning, can be used to derive ICP from waveform features in NHP with validation against invasive neuromonitors and CBF data from DCS 109 …”

Section: Challenges and Future Applicationsmentioning

confidence: 99%

Applications of near-infrared spectroscopy in neurocritical care

2023

View full text Add to dashboard Cite

Acute brain injuries are commonly encountered in the intensive care unit. Alterations in cerebrovascular physiology triggered by the initial insult can lead to neurological worsening, further brain injury, and poor outcomes. Robust methods for assessing cerebrovascular physiology continuously at the bedside are limited. Aim:In this review, we aim to assess the potential of near-infrared spectroscopy (NIRS) as a bedside tool to monitor cerebrovascular physiology in critically ill patients with acute brain injury as well as those who are at high risk for developing brain injury.Approach: We first review basic principles of cerebral blood flow regulation and how these are altered after brain injury. We then discuss the potential role for NIRS in different acute brain injuries. We pay specific attention to the potential for NIRS to (1) identify new brain injuries and clinical worsening, (2) non-invasively measure intracranial pressure (ICP) and cerebral autoregulation, and (3) identify optimal blood pressure (BP) targets that may improve patient outcomes.Results: A growing body of work supports the use of NIRS in the care of brain injured patients. NIRS is routinely used during cardiac surgeries to identify acute neurologic events, and there is some evidence that treatment algorithms using cerebral oximetry may result in improved outcomes. In acute brain injury, NIRS can be used to measure autoregulation to identify an "optimum" BP where autoregulation status is best preserved. Finally, NIRS has been utilized to identify oximetry thresholds that correlate with poor outcome as well as identify new focal intracranial hemorrhages.Conclusions: NIRS is emerging as a tool that can non-invasively measure brain function in critically ill patients. Future work will be aimed at technical refinements to improve diagnostic accuracy, as well as larger scale clinical trials that can establish a definitive impact on patient outcomes.

show abstract

Estimating intracranial pressure using pulsatile cerebral blood flow measured with diffuse correlation spectroscopy: erratum

Cited by 5 publications

References 1 publication

Advanced Neuromonitoring Modalities on the Horizon: Detection and Management of Acute Brain Injury in Children

Advanced Neuromonitoring Modalities on the Horizon: Detection and Management of Acute Brain Injury in Children

A pilot clinical study to estimate intracranial pressure utilising cerebral photoplethysmograms in traumatic brain injury patients

Applications of near-infrared spectroscopy in neurocritical care

Contact Info

Product

Resources

About