Hyperspectral near infrared spectroscopy assessment of the brain during hypoperfusion

摘要

Two-thirds of out-of-hospital cardiac arrest patients, who survive to hospital admission, die in the hospital from neurological injuries related to cerebral hypoperfusion. Hyperspectral near infrared spectroscopy (hNIRS) is a noninvasive technique that measures the major chromophores in the brain, such as oxygenated hemoglobin, deoxygenated hemoglobin and cytochrome C oxidase ([CCO]), an intracellular marker of oxygen consumption. We have demonstrated that hNIRS is feasible and can detect changes in cerebral oxygenation and metabolism in patients undergoing transcatheter aortic valve insertion (TAVI) - a procedure that temporarily induces sudden hypotension and hypoperfusion that mimics cardiac arrest. Using multi-distance hNIRS, we found that while measured regional oxygen saturation (rS02) changes resulted mainly from the extra-cerebral tissues, [CCO] changes during cardiac arrests occurred mainly in the brains of patients. We also applied the hNIRS algorithm based on the "2-layer model" to the data to measure cerebral oxygen saturation and [CCO] in patients during the procedure.