Near-Infrared Spectroscopy in Neurocritical Care: A Review of Recent Updates

Viderman, Dmitriy; Abdildin, Yerkin G.

doi:10.1016/j.wneu.2021.04.054

Cited by 10 publications

(4 citation statements)

References 52 publications

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“…They have studied continuous non-destructive monitoring of ICP changes caused by brain edema based on near-infrared spectroscopy [ 10 ]. However, its penetrability is much weaker to human tissues, especially the skull, and the detection sensitivity of lesions in the deep position is significantly reduced [ 11 ]. Bioelectrical impedance can inject current from the skull surface to intracalvarium by electrode, and measure the changes of boundary potential to realize the non-invasive dynamic monitoring of cerebral edema [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Point-of-care testing for cerebral edema types based on symmetric cancellation near-field coupling phase shift and support vector machine

Zhu

et al. 2023

BioMed Eng OnLine

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Background Cerebral edema is an extremely common secondary disease in post-stroke. Point-of-care testing for cerebral edema types has important clinical significance for the precise management to prevent poor prognosis. Nevertheless, there has not been a fully accepted bedside testing method for that. Methods A symmetric cancellation near-field coupling phase shift (NFCPS) monitoring system is established based on the symmetry of the left and right hemispheres and the fact that unilateral lesions do not affect healthy hemispheres. For exploring the feasibility of this system to reflect the occurrence and development of cerebral edema, 13 rabbits divided into experimental group (n = 8) and control group (n = 5) were performed 24-h NFCPS continuous monitoring experiments. After time difference offset and feature band averaging processing, the changing trend of NFCPS at the stages dominated by cytotoxic edema (CE) and vasogenic edema (VE), respectively, was analyzed. Furthermore, the features under the different time windows were extracted. Then, a discriminative model of cerebral edema types based on support vector machines (SVM) was established and performance of multiple feature combinations was compared. Results The NFCPS monitoring outcomes of experimental group endured focal ischemia modeling by thrombin injection show a trend of first decreasing and then increasing, reaching the lowest value of − 35.05° at the 6th hour. Those of control group do not display obvious upward or downward trend and only fluctuate around the initial value with an average change of − 0.12°. Furthermore, four features under the 1-h and 2-h time windows were extracted. Based on the discriminative model of cerebral edema types, the classification accuracy of 1-h window is higher than 90% and the specificity is close to 1, which is almost the same as the performance of the 2-h window. Conclusion This study proves the feasibility of NFCPS technology combined with SVM to distinguish cerebral edema types in a short time, which is promised to become a new solution for immediate and precise management of dehydration therapy after ischemic stroke.

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Section: Introductionmentioning

confidence: 99%

Point-of-care testing for cerebral edema types based on symmetric cancellation near-field coupling phase shift and support vector machine

Zhu

et al. 2023

BioMed Eng OnLine

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“…NIRS is a noninvasive technique in which scalp-based electrodes emit light in the near-infrared spectrum and then capture signals reflected from underlying tissue including brain; the relative concentration of oxy-hemoglobin and deoxy-hemoglobin is determined based on their differential light absorption spectra. When obtained in conjunction with simultaneously recorded systemic arterial blood pressure, NIRS time series data can be used to compute different autoregulation indices such as the cerebral oximetry index (Cox), tissue oxygen index (Tox) and hemoglobin volume index (HVx)[33].…”

Section: Near Infrared Spectroscopymentioning

confidence: 99%

Neuromonitoring in the ICU – what, how and why?

Mathur,

Meyfroidt,

Robba

et al. 2024

Current Opinion in Critical Care

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Purpose of review We selectively review emerging noninvasive neuromonitoring techniques and the evidence that supports their use in the ICU setting. The focus is on neuromonitoring research in patients with acute brain injury. Recent findings Noninvasive intracranial pressure evaluation with optic nerve sheath diameter measurements, transcranial Doppler waveform analysis, or skull mechanical extensometer waveform recordings have potential safety and resource-intensity advantages when compared to standard invasive monitors, however each of these techniques has limitations. Quantitative electroencephalography can be applied for detection of cerebral ischemia and states of covert consciousness. Near-infrared spectroscopy may be leveraged for cerebral oxygenation and autoregulation computation. Automated quantitative pupillometry and heart rate variability analysis have been shown to have diagnostic and/or prognostic significance in selected subtypes of acute brain injury. Finally, artificial intelligence is likely to transform interpretation and deployment of neuromonitoring paradigms individually and when integrated in multimodal paradigms. Summary The ability to detect brain dysfunction and injury in critically ill patients is being enriched thanks to remarkable advances in neuromonitoring data acquisition and analysis. Studies are needed to validate the accuracy and reliability of these new approaches, and their feasibility and implementation within existing intensive care workflows.

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“…"Near-infrared spectroscopy (NIRS)" offers a noninvasive bedside measurement of direct regional cerebral arteriovenous (mixed) brain oxygenation using wavelength-dependent light attenuation to measure hemoglobin concentration (Fig. 2) (35,(64)(65)(66)(67). It is most useful in serial monitoring for scenarios where patients can serve as their own controls since it calculates changes from baseline, rather than absolute oxygenation values (67).…”

Section: Cerebral Oxygenationmentioning

confidence: 99%

Neuromonitoring in Critically Ill Patients

Rajagopalan

Sarwal

2023

Critical Care Medicine

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OBJECTIVES: Critically ill patients are at high risk of acute brain injury. Bedside multimodality neuromonitoring techniques can provide a direct assessment of physiologic interactions between systemic derangements and intracranial processes and offer the potential for early detection of neurologic deterioration before clinically manifest signs occur. Neuromonitoring provides measurable parameters of new or evolving brain injury that can be used as a target for investigating various therapeutic interventions, monitoring treatment responses, and testing clinical paradigms that could reduce secondary brain injury and improve clinical outcomes. Further investigations may also reveal neuromonitoring markers that can assist in neuroprognostication. We provide an up-to-date summary of clinical applications, risks, benefits, and challenges of various invasive and noninvasive neuromonitoring modalities. DATA SOURCES: English articles were retrieved using pertinent search terms related to invasive and noninvasive neuromonitoring techniques in PubMed and CINAHL. STUDY SELECTION: Original research, review articles, commentaries, and guidelines. DATA EXTRACTION: Syntheses of data retrieved from relevant publications are summarized into a narrative review. DATA SYNTHESIS: A cascade of cerebral and systemic pathophysiological processes can compound neuronal damage in critically ill patients. Numerous neuromonitoring modalities and their clinical applications have been investigated in critically ill patients that monitor a range of neurologic physiologic processes, including clinical neurologic assessments, electrophysiology tests, cerebral blood flow, substrate delivery, substrate utilization, and cellular metabolism. Most studies in neuromonitoring have focused on traumatic brain injury, with a paucity of data on other clinical types of acute brain injury. We provide a concise summary of the most commonly used invasive and noninvasive neuromonitoring techniques, their associated risks, their bedside clinical application, and the implications of common findings to guide evaluation and management of critically ill patients. CONCLUSIONS: Neuromonitoring techniques provide an essential tool to facilitate early detection and treatment of acute brain injury in critical care. Awareness of the nuances of their use and clinical applications can empower the intensive care team with tools to potentially reduce the burden of neurologic morbidity in critically ill patients.

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Near-Infrared Spectroscopy in Neurocritical Care: A Review of Recent Updates

Cited by 10 publications

References 52 publications

Point-of-care testing for cerebral edema types based on symmetric cancellation near-field coupling phase shift and support vector machine

Point-of-care testing for cerebral edema types based on symmetric cancellation near-field coupling phase shift and support vector machine

Neuromonitoring in the ICU – what, how and why?

Neuromonitoring in Critically Ill Patients

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