The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrests

Zavriyev, Alexander I.; Kaya, Kutlu; Farzam, Parya; Sunwoo, John; Jassar, Arminder S.; Sundt, Thoralf M.; Carp, Stefan A.; Franceschini, Maria Angela; Qu, Jason

doi:10.1016/j.xjtc.2021.01.023

Cited by 20 publications

(11 citation statements)

References 43 publications

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“…Zavriyevet al ( 2021) have recently reported on the tandem use of DCS and frequency resolved NIRS to measure CBF and CMRO 2 concurrently in 12 patients undergoing elective cardiac surgery with hypothermic circulatory arrest. The found that the information provided by these devices was able to help achieve patient specific optimal brain perfusion (Zavriyev et al, 2021). In a similar study, Rajaram et al (2020) explored the hybrid NIRS system that combined DCS and fixed wavelength NIRS to examine CBF and the cerebral oxidation state of CCO in 10 patients undergoing cardiac surgery with cardiopulmonary bypass.…”

Section: Near-infrared Spectroscopy In Intraoperative Monitoring Of Traumatic Brain Injury Patientsmentioning

confidence: 99%

Near Infrared Spectroscopy for High-Temporal Resolution Cerebral Physiome Characterization in TBI: A Narrative Review of Techniques, Applications, and Future Directions

et al. 2021

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Multimodal monitoring has been gaining traction in the critical care of patients following traumatic brain injury (TBI). Through providing a deeper understanding of the individual patient’s comprehensive physiologic state, or “physiome,” following injury, these methods hold the promise of improving personalized care and advancing precision medicine. One of the modalities being explored in TBI care is near-infrared spectroscopy (NIRS), given it’s non-invasive nature and ability to interrogate microvascular and tissue oxygen metabolism. In this narrative review, we begin by discussing the principles of NIRS technology, including spatially, frequency, and time-resolved variants. Subsequently, the applications of NIRS in various phases of clinical care following TBI are explored. These applications include the pre-hospital, intraoperative, neurocritical care, and outpatient/rehabilitation setting. The utility of NIRS to predict functional outcomes and evaluate dysfunctional cerebrovascular reactivity is also discussed. Finally, future applications and potential advancements in NIRS-based physiologic monitoring of TBI patients are presented, with a description of the potential integration with other omics biomarkers.

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Section: Near-infrared Spectroscopy In Intraoperative Monitoring Of Traumatic Brain Injury Patientsmentioning

confidence: 99%

Near Infrared Spectroscopy for High-Temporal Resolution Cerebral Physiome Characterization in TBI: A Narrative Review of Techniques, Applications, and Future Directions

et al. 2021

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“… 10 , 11 The combination of NIRS and DCS has been used to measure CBF and

in clinical studies involving neonatal and adult patient populations. 12 – 16 …”

Section: Introductionmentioning

confidence: 99%

“…10,11 The combination of NIRS and DCS has been used to measure CBF and CMRO 2 in clinical studies involving neonatal and adult patient populations. [12][13][14][15][16] Due to the unique light-absorbing properties of cytochrome-c-oxidase (CCO), NIRS offers an alternative approach for assessing oxygen metabolism by measuring changes in the oxidation state of CCO (oxCCO). 17 This metabolic marker is directly related to mitochondrial ATP production and has the advantage of not requiring separate measurements of CBF and S a O 2 , nor does it depend on assuming a fixed arteriovenous blood volume ratio required to convert S t O 2 to venous oxygen saturation as required to determine CMRO 2 .…”

Section: Introductionmentioning

confidence: 99%

Assessing the relationship between the cerebral metabolic rate of oxygen and the oxidation state of cytochrome-c-oxidase

et al. 2022

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Significance: Hyperspectral near-infrared spectroscopy (hsNIRS) combined with diffuse correlation spectroscopy (DCS) provides a noninvasive approach for monitoring cerebral blood flow (CBF), the cerebral metabolic rate of oxygen (CMRO 2 ) and the oxidation state of cytochromec-oxidase (oxCCO). CMRO 2 is calculated by combining tissue oxygen saturation (S t O 2 ) with CBF, whereas oxCCO can be measured directly by hsNIRS. Although both reflect oxygen metabolism, a direct comparison has yet to be studied. Aim:We aim to investigate the relationship between CMRO 2 and oxCCO during periods of restricted oxygen delivery and lower metabolic demand.Approach: A hybrid hsNIRS/DCS system was used to measure hemodynamic and metabolic responses in piglets exposed to cerebral ischemia and anesthetic-induced reductions in brain activity.Results: Although a linear relationship was observed between CMRO 2 and oxCCO during ischemia, both exhibited a nonlinear relationship with respect to CBF. In contrast, linear correlation was sufficient to characterize the relationships between CMRO 2 and CBF and between the two metabolic markers during reduced metabolic demand. Conclusions:The observed relationship between CMRO 2 and oxCCO during periods of restricted oxygen delivery and lower metabolic demand indicates that the two metabolic markers are strongly correlated.

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“…In this article from Boston, Zavriyev and colleagues 1 look to demonstrate the benefits and use of real-time noninvasive monitoring of cerebral blood flow during cardiac surgery requiring hypothermic circulatory arrest in adult cardiac surgical patients. The authors monitored cerebral blood flow during different brain-protection techniques using diffuse correlation spectroscopy in 12 patients undergoing cardiac surgery with hypothermic circulatory arrest.…”

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confidence: 99%

Commentary: Measurement of real-time cerebral blood flow during cardiac surgery—A useful tool?

Chai

2021

JTCVS Techniques

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In this article from Boston, Zavriyev and colleagues 1 look to demonstrate the benefits and use of real-time noninvasive monitoring of cerebral blood flow during cardiac surgery requiring hypothermic circulatory arrest in adult cardiac surgical patients. The authors monitored cerebral blood flow during different brain-protection techniques using diffuse correlation spectroscopy in 12 patients undergoing cardiac surgery with hypothermic circulatory arrest. Diffuse correlation spectroscopy differs from the widely used NIRS (near-infrared spectroscopy) by providing an index of cerebral blood flow.Using this technique, the authors were able to measure cerebral oxygen saturation, cerebral blood flow, and cerebral metabolic rate of oxygen consumption (CMRO 2 ) during cardiac surgery with hypothermic circulatory arrest. Measurements revealed that negligible amounts of blood were delivered to the brain during circulatory arrest with retrograde cerebral perfusion or circulatory arrest alone. Cerebral blood flow was significantly greater during the use of antegrade cerebral perfusion, however. The authors concluded that this technique could be a powerful tool to optimize cerebral perfusion and that retrograde cerebral perfusion needs to be further examined to confirm its efficacy.The article demonstrates a new technique for noninvasive, real-time measurement of cerebral blood flow. With the concurrent use of NIRS, this also gives the ability to

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The role of diffuse correlation spectroscopy and frequency-domain near-infrared spectroscopy in monitoring cerebral hemodynamics during hypothermic circulatory arrests

Cited by 20 publications

References 43 publications

Near Infrared Spectroscopy for High-Temporal Resolution Cerebral Physiome Characterization in TBI: A Narrative Review of Techniques, Applications, and Future Directions

Near Infrared Spectroscopy for High-Temporal Resolution Cerebral Physiome Characterization in TBI: A Narrative Review of Techniques, Applications, and Future Directions

Assessing the relationship between the cerebral metabolic rate of oxygen and the oxidation state of cytochrome-c-oxidase

Commentary: Measurement of real-time cerebral blood flow during cardiac surgery—A useful tool?

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