Frequency domain diffuse optical spectroscopy and diffuse correlation spectroscopy for assessing inspiratory muscle metabolism in mechanically ventilated patients

频域漫反射光谱和漫相关光谱用于评估机械通气患者的吸气肌代谢

• 批准号: 10482330
• 负责人: Darren Michael Roblyer
• 金额: $ 20.08万
• 依托单位: BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-15 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10482330
• 关键词: Accounting; Address; Algorithms; Benchmarking; Blood flow; Boa; Boston; Breathing; COVID-19; COVID-19 pandemic; Cardiogenic Shock; Clinical; Critical Illness; Custom; Detection; Development; Devices; Diffuse; Disuse Atrophy; Electronics; Expenditure; Failure; Feasibility Studies; Feedback; Frequencies; Functional disorder; Funding; Future; Heart Diseases; Hospital Costs; Inflammation; Lead; Link; Lipids; Measurement; Measures; Mechanical ventilation; Metabolic; Metabolism; Methodology; Modeling; Monitor; Morbidity - disease rate; Muscle; Optics; Organ; Oxidative Stress; Oxygen; Patients; Performance; Phase; Physicians; Population; Procedures; Property; Research; Respiratory Diaphragm; Respiratory Disease; Respiratory Muscles; Scientist; Septic Shock; Skin; Spectrum Analysis; Speed; Sternocleidomastoid Muscle; System; Techniques; Technology; Testing; Therapeutic; Thick; Time; Tissues; Variant; Ventilator; Weaning; Work; base; computerized data processing; deep neural network; digital; disability; healthy volunteer; human subject; improved; improved outcome; indexing; metabolic rate; mortality; muscle metabolism; muscle physiology; novel; respiratory; septic; subcutaneous; success; technology development; temporal measurement; trend

PROJECT SUMMARY Mechanical ventilation (MV), which is used to assist or replace spontaneous breathing in critically ill patients, led to $27 billion in expenditures in the US in 2010, accounting for 12% of all hospital costs. In that same year there were 2.7 episodes of MV per 1000 population, highlighting the enormous importance of this procedure. The COVID-19 pandemic has substantially increased these numbers, although precise rates are not yet available. MV is used, in part, to “unload”, or reduce the metabolic effort of respiratory muscles in order to redirect oxygen delivery to vital organs. As the patients’ conditions improve, key inspiratory muscles (e.g. diaphragm, scalenes, sternomastoid, etc.) need to take over spontaneous breathing independent of the ventilator. This “reloading” is precarious due to muscle disuse atrophy, induced by unloading. This is further complicated by other common conditions such as septic or cardiogenic shock, which can severely limit oxygen delivery independent of muscle status. What’s needed is a methodology that can continuously monitor blood flow and oxygen utilization of inspiratory muscles so that respiratory effort can be continuously optimized during MV. This project aims to develop a comprehensive blood flow index, oxygenation, and metabolic measurement platform for inspiratory muscle physiology by integrating wideband frequency-domain diffuse optical spectroscopy (wbDOS) and diffuse correlation spectroscopy (DCS) to tackle this unmet need. wbDOS is a new all-digital frequency-domain DOS technique that captures amplitude and phase measurements over a wide bandwidth of modulation frequencies (50-500 MHz) at high speeds (>100 Hz). wbDOS and DCS will combine synergistically to provide pathlength- corrected estimates of absolute Hb/Mb concentrations and blood flow index (BFi), allowing for the extraction of tissue regional oxygen metabolic rate (MRO2i), a parameter directly linked to oxygen utilization. We hypothesize that wbDOS and DCS measurements can be acquired simultaneously at high speed (>10 Hz) with parallel detection and integrated electronics. This speed is needed to capture inspiratory/expiratory dynamics at the respiratory rate. Additionally, we hypothesize wideband frequency-domain DOS measurements will provide improved quantification of optical properties, BFi and MRO2i when optically integrated with DCS as compared to single frequency FD-DOS or CW-NIRS. We will validate this through rigorous system testing using flow-channel tissue-mimicking optical phantoms. A multi-layer inverse model will be developed to better capture inspiratory muscle metabolism by accounting for subcutaneous lipid thickness and skin tones. We will also expand on our recent work in Deep Neural Network (DNN) processing to develop high-speed algorithms for calculating Hb/Mb concentrations, StO2 (%), BFi (mm2/s), and MRO2i at 10 Hz. We will conduct a feasibility study (n=10) of healthy volunteers during respiratory muscle loading and unloading to evaluate performance compared to expected trends. It is anticipated that completion of these aims will yield a novel and comprehensive blood flow index, oxygenation, and metabolic measurement platform (wbDOS-DCS) and lead to subsequent R01-scale funding.

项目概要 机械通气（MV）用于辅助或替代危重患者的自主呼吸， 2010 年美国的支出达到 270 亿美元，占当年所有医院费用的 12%。 每 1000 人中有 2.7 次 MV 发作，凸显了该手术的巨大重要性。 尽管尚不清楚确切的比率，但 COVID-19 大流行已大幅增加了这些数字。 MV 部分用于“卸载”或减少呼吸肌的代谢努力，以改变氧气的方向 随着患者病情的改善，关键的吸气肌（例如膈肌、斜角肌、 胸乳突肌等）需要独立于呼吸机接管自主呼吸，这种“重新加载”是。 由于肌肉废用性萎缩、卸载引起的不稳定，这会因其他常见情况而进一步复杂化。 脓毒症或心源性休克等疾病，会严重限制氧气输送，与肌肉无关 我们需要一种能够持续监测血液流量和氧气利用率的方法。 吸气肌，以便在 MV 期间不断优化呼吸努力。 开发吸气综合血流指数、氧合和代谢测量平台 通过集成宽带频域漫反射光谱 (wbDOS) 和漫反射来研究肌肉生理学 相关光谱 (DCS) 解决了这一未满足的需求，wbDOS 是一种新的全数字频域 DOS。 在宽调制频率带宽上捕获幅度和相位测量的技术 (50-500 MHz) 高速 (>100 Hz) wbDOS 和 DCS 将协同结合以提供路径长度。 修正了绝对 Hb/Mb 浓度和血流指数 (BFi) 的估计值，允许提取 组织局部氧代谢率（MRO2i），一个与氧利用率直接相关的参数。 wbDOS 和 DCS 测量可以同时高速 (>10 Hz) 并行采集 检测和集成电子设备需要这种速度来捕获吸气/呼气动态。 此外，我们还将提供宽带频域 DOS 测量。 与 DCS 光学集成时，改进了光学特性、BFi 和 MRO2i 的量化 我们将使用流道通过严格的系统测试来验证这一点。 将开发模拟组织的光学模型，以更好地捕获吸气。 我们还将通过考虑皮下脂质厚度和肤色来扩展肌肉代谢。 最近在深度神经网络 (DNN) 处理方面的工作，开发用于计算 Hb/Mb 的高速算法 10 Hz 时的浓度、StO2 (%)、BFi (mm2/s) 和 MRO2i 我们将对健康人群进行可行性研究 (n=10)。 志愿者在呼吸肌加载和卸载过程中评估表现与预期的比较 预计这些目标的完成将产生新颖且全面的血流指数， 氧合和代谢测量平台 (wbDOS-DCS) 并导致随后的 R01 规模资金。

项目成果

A combined frequency domain near infrared spectroscopy and diffuse correlation spectroscopy system for comprehensive metabolic monitoring of inspiratory muscles during loading.

组合频域近红外光谱和漫相关光谱系统，用于加载期间吸气肌的全面代谢监测。

• 发表时间: 2023-12-01
• 作者: Gómez, Carlos A;Brochard, Laurent;Goligher, Ewan C;Rozenberg, Dmitry;Reid, W Darlene;Roblyer, Darren
• 通讯作者: Roblyer, Darren

Combined frequency domain near-infrared spectroscopy and diffuse correlation spectroscopy system for comprehensive metabolic monitoring of inspiratory muscles during loading.

频域近红外光谱和漫相关光谱系统相结合，用于负荷过程中吸气肌的全面代谢监测。

• 发表时间: 2024-03
• 影响因子: 3.5
• 作者: Gómez, Carlos A;Brochard, Laurent;Goligher, Ewan C;Rozenberg, Dmitry;Reid, W Darlene;Roblyer, Darren
• 通讯作者: Roblyer, Darren