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Part of book or chapter of book . 2015
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Detection of Delayed Cerebral Ischemia (DCI) in Subarachnoid Haemorrhage Applying Near-Infrared Spectroscopy: Elimination of the Extracerebral Signal by Transcutaneous and Intraparenchymatous Measurements in Parallel

Authors: Keller, Emanuela; Fröhlich, Jürg; Baumann, Dirk; Böcklin, Christoph; Sikorski, Christopher; Oberle, Michael; Muser, Markus H;

Detection of Delayed Cerebral Ischemia (DCI) in Subarachnoid Haemorrhage Applying Near-Infrared Spectroscopy: Elimination of the Extracerebral Signal by Transcutaneous and Intraparenchymatous Measurements in Parallel

Abstract

Detection of delayed cerebral ischemia (DCI) in high-grade subarachnoid haemorrhage (SAH) is an unsolved issue. Conventional near-infrared spectroscopy (NIRS) with optodes applied over the skin is controversial because the NIRS signal is contaminated by extracerebral tissue. The objective is to quantify and subtract the contribution from extracerebral tissue from the signal by using measurements in parallel with a NIRS brain tissue probe and conventional NIRS.In a patient with high-grade SAH, two approaches for NIRS were applied. First, a conventional brain tissue probe for intracranial pressure (ICP) monitoring, supplied by optical fibres, was placed into the brain tissue 2 cm deep from the dura. Second, for conventional NIRS, a plaster-based patch carrying optodes (one emitter, two detectors) was attached to the skin. Central venous injections of 0.3 mg/kg body weight (bw) indocyanine green (ICG) were performed. ICG dye dilution curves obtained with the probe and patch were collected simultaneously and analysed for blood flow values.Twelve measurements in parallel with the probe and patch were performed. Mean cerebral blood flow (CBF) for the probe was higher (24.8 ± 9.1 ml/100 g/min) compared with the values obtained with the patch (for detector 1, extra-cerebral blood flow [ECBF] mean 5.1 ± 1.8 ml/100 g/min; p = 0.002; for detector 2, 6.6 ± 2.1 ml/100 g/min; p = 0.002). CBF values obtained with the probe correlated with blood flow values obtained with the patch (for CBF vs. ECBF detector 1, r = 0.72 [p = 0.008]; ECBF detector 2, r = 0.79 [p = 0.002]).Blood flow values obtained with conventional NIRS correlated significantly with absolute CBF values obtained directly within the brain tissue. Simultaneous measurements with the NeMo Probe and NeMo Patch allow quantification and subtraction of the contribution from extracerebral tissues from the signal obtained with conventional NIRS.

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Keywords

Indocyanine Green, Spectroscopy, Near-Infrared, Time Factors, Intracranial Pressure, 610 Medicine & health, Signal Processing, Computer-Assisted, Subarachnoid Hemorrhage, 2746 Surgery, Brain Ischemia, 10180 Clinic for Neurosurgery, 2728 Neurology (clinical), Blood Circulation Time, Cerebrovascular Circulation, Humans, Computer Simulation, 10023 Institute of Intensive Care Medicine, Coloring Agents, Monte Carlo Method, Algorithms, Monitoring, Physiologic

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
12
Top 10%
Average
Average