Optical monitoring of cerebral oxygenation in infants

婴儿脑氧合的光学监测

• 批准号: 6729110
• 负责人: Maria Angela Franceschini
• 金额: $ 37.25万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-07-01 至 2006-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6729110
• 关键词: biomedical equipment development; brain disorder diagnosis; brain injury; cerebrovascular system; clinical biomedical equipment; clinical research; early diagnosis; human subject; infrared spectrometry; injury prevention; newborn human (0-6 weeks); oximetry; oxygen tension; oxygen transport; patient monitoring device; patient oriented research; respiratory oxygenation; swine

DESCRIPTION (provided by applicant): Oxygen deprivation, typically the result of a combination of hypoxia and hypoperfusion, is often the primary event setting off a biochemical cascade that leads to irreversible brain injury in perinatal encephalopathy. The long-term objective of this project is the development of a novel near-infrared spectroscopy (NIRS) device for the continuous monitoring of the regional tissue saturation (St02), arterial saturation (Sa02), and venous saturation (Sv02) in the neonate's brain. Such a device could potentially detect brain tissue compromise before the development of irreversible structural damage, thus allowing for timely and specific intervention. The novelty of our approach relates to the hypothesis that an appropriate temporal analysis of NIRS data can yield three different oxygenation measurements: (1) St02 from the temporal average of the optical signal; (2) Sa02 from the oscillating component of the optical absorption at the pulse frequency; (3) Sv02 from the oscillating component of the optical absorption at the respiratory frequency. The short-term goals of this project are to characterize NIRS measurements of cerebral oxygenation and to identify the most effective practical implementation of NIRS (in terms of instrumentation and data processing) for non-invasive cerebral oximetry. In particular, we aim to 1 ) investigate the relationship between the local measurements of the hemoglobin oxygenation in the cerebral tissue, in the arterial vascular compartment, and in the venous vascular compartment, and 2) perform spatially resolved measurements of cerebral oxygenation to localize areas of brain damage. To achieve our short-term goals, we propose to perform measurements on an animal model (piglets) where we can induce changes in the hemoglobin oxygenation levels over a large range, where we can perform hemodilution experiments, where we can induce focal brain injury, and where we have access to invasive readings of Sa02 and Sv02 from the gas analysis of blood samples. Finally we will test our proposed NIRS approach to cerebral oximetry on human neonates. The completion of this study will lead to the characterization of NIRS oximetry of the brain, to the development of multimode optical oximetry (simultaneous local measurement of St02, Sa02, and Sv02), and to the identification of the most effective approach to the non-invasive. continuous monitoring of cerebral oxygenation in neonates.

描述（由申请人提供）：氧气剥夺通常是缺氧和灌注不足的组合的结果，通常是导致围产期脑病中不可逆脑损伤的生化级联反应的主要事件。该项目的长期目标是开发新的近红外光谱（NIRS）装置，用于连续监测新生儿大脑中区域组织饱和度（ST02），动脉饱和度（SA02）和静脉饱和度（SV02）。这种装置可能会在发展不可逆的结构损伤之前可能会检测到脑组织的损害，从而允许及时和特定的干预。我们方法的新颖性涉及以下假设：NIRS数据的适当时间分析可以产生三种不同的氧合测量：（1）ST02来自光信号的时间平均值； （2）从脉冲频率下光吸收的振荡成分的SA02； （3）从呼吸频率下光吸收的振荡成分的SV02。该项目的短期目标是表征脑充氧的NIRS测量值，并确定非侵入性大脑血氧仪的NIR（在仪器和数据处理方面）最有效的实际实施。特别是，我们的目的是1）研究大脑组织中血红蛋白氧合的局部测量，动脉血管室中的局部测量，在静脉血管室中，以及2）进行空间分辨的大脑氧合局部损伤区域的大脑氧合的测量值。为了实现我们的短期目标，我们建议对动物模型（小猪）进行测量，在该模型（小猪）中，我们可以在较大范围内诱导血红蛋白氧合水平的变化，我们可以在其中进行液化实验，我们可以诱导局灶性脑损伤，以及我们可以从SA02和SV02的侵入性读取中，从SA02和SV02进行血液分析。最后，我们将测试我们在人类新生儿的脑血氧中提出的NIRS方法。这项研究的完成将导致大脑NIRS血氧仪的表征，发展多模光氧学（同时局部测量ST02，SA02和SV02），并确定了最有效的无创方法。连续监测新生儿的大脑氧合。