Original Article

Neurocritical Care

, Volume 12, Issue 2, pp 173-180

Noninvasive Measurement of Cerebral Blood Flow and Blood Oxygenation Using Near-Infrared and Diffuse Correlation Spectroscopies in Critically Brain-Injured Adults

  • Meeri N. KimAffiliated withDepartment of Physics and Astronomy, University of Pennsylvania Email author 
  • , Turgut DurduranAffiliated withDepartment of Physics and Astronomy, University of PennsylvaniaDepartment of Radiology, University of PennsylvaniaICFO—Institut de Ciències Fotòniques
  • , Suzanne FrangosAffiliated withDepartment of Neurosurgery, University of Pennsylvania
  • , Brian L. EdlowAffiliated withDepartment of Neurology, University of Pennsylvania
  • , Erin M. BuckleyAffiliated withDepartment of Physics and Astronomy, University of Pennsylvania
  • , Heather E. MossAffiliated withDepartment of Neurology, University of Pennsylvania
  • , Chao ZhouAffiliated withDepartment of Physics and Astronomy, University of Pennsylvania
  • , Guoqiang YuAffiliated withDepartment of Physics and Astronomy, University of PennsylvaniaCenter for Biomedical Engineering, University of Kentucky
  • , Regine ChoeAffiliated withDepartment of Physics and Astronomy, University of Pennsylvania
    • , Eileen Maloney-WilenskyAffiliated withDepartment of Neurosurgery, University of Pennsylvania
    • , Ronald L. WolfAffiliated withDepartment of Radiology, University of Pennsylvania
    • , M. Sean GradyAffiliated withDepartment of Neurosurgery, University of Pennsylvania
    • , Joel H. GreenbergAffiliated withDepartment of Neurology, University of Pennsylvania
    • , Joshua M. LevineAffiliated withDepartment of Neurosurgery, University of PennsylvaniaDepartment of Neurology, University of PennsylvaniaDepartment of Anesthesiology and Critical Care, University of Pennsylvania
    • , Arjun G. YodhAffiliated withDepartment of Physics and Astronomy, University of Pennsylvania
    • , John A. DetreAffiliated withDepartment of Radiology, University of PennsylvaniaDepartment of Neurology, University of Pennsylvania
    • , W. Andrew KofkeAffiliated withDepartment of Neurosurgery, University of PennsylvaniaDepartment of Anesthesiology and Critical Care, University of Pennsylvania

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Abstract

Background

This study assesses the utility of a hybrid optical instrument for noninvasive transcranial monitoring in the neurointensive care unit. The instrument is based on diffuse correlation spectroscopy (DCS) for measurement of cerebral blood flow (CBF), and near-infrared spectroscopy (NIRS) for measurement of oxy- and deoxy-hemoglobin concentration. DCS/NIRS measurements of CBF and oxygenation from frontal lobes are compared with concurrent xenon-enhanced computed tomography (XeCT) in patients during induced blood pressure changes and carbon dioxide arterial partial pressure variation.

Methods

Seven neurocritical care patients were included in the study. Relative CBF measured by DCS (rCBFDCS), and changes in oxy-hemoglobin (ΔHbO2), deoxy-hemoglobin (ΔHb), and total hemoglobin concentration (ΔTHC), measured by NIRS, were continuously monitored throughout XeCT during a baseline scan and a scan after intervention. CBF from XeCT regions-of-interest (ROIs) under the optical probes were used to calculate relative XeCT CBF (rCBFXeCT) and were then compared to rCBFDCS. Spearman’s rank coefficients were employed to test for associations between rCBFDCS and rCBFXeCT, as well as between rCBF from both modalities and NIRS parameters.

Results

rCBFDCS and rCBFXeCT showed good correlation (r s = 0.73, P = 0.010) across the patient cohort. Moderate correlations between rCBFDCS and ΔHbO2/ΔTHC were also observed. Both NIRS and DCS distinguished the effects of xenon inhalation on CBF, which varied among the patients.

Conclusions

DCS measurements of CBF and NIRS measurements of tissue blood oxygenation were successfully obtained in neurocritical care patients. The potential for DCS to provide continuous, noninvasive bedside monitoring for the purpose of CBF management and individualized care is demonstrated.

Keywords

Near-infrared spectroscopy Diffuse correlation spectroscopy Cerebral blood flow Xenon CT Neurocritical care